A blended future?
Also at EPA 2021, two experts debated whether the COVID-19 pandemic represented a turning point for e-health in psychiatry.
Taking the pro stance, Heleen Riper, PhD, professor of eMental-Health at the Vrije Universiteit Amsterdam, argued that the future is likely to blend face-to-face interaction with video conferencing.
She believes that to maintain current progress, the focus should be on treatment personalization, engagement, and improvement, rather than cost-effectiveness.
Hans-Jürgen Möller, MD, professor emeritus, department of psychiatry, Ludwig-Maximilians-University, Munich, argued against the idea that e-health represented a turning point in psychiatry. He noted that a survey of German psychotherapists indicated that there have been a number of drawbacks to video sessions during the pandemic.
Dr. Hans-Jürgen Möller
These included that the technology was not available or could be used by all patients, especially the elderly, and that unstable internet connections have posed a problem. Moreover, video conferencing is considered a “poor substitute” for face-to-face interactions by many patients.
In the subsequent discussion, Dr. Möller told this news organization that he believes guidelines in this area are important, especially to differentiate among various offerings on the internet, some of which are “not very good,” and to help patients identify those that are “very well established.”
Dr. Riper agreed, saying that several initiatives to introduce guidelines at the European level are now underway.
The biggest challenge from a technological standpoint is to offer flexibility to patients while still applying “therapeutic principles,” she noted.
“There is a need for guidelines, but those guidelines need to be open to a certain amount of flexibility if you really want to upscale technology into routine care,” Dr. Riper said.
Cautious optimism
Session chair Judit Simon, MD, DPhil, professor of health economics, Medical University of Vienna, asked the debaters whether video interventions will continue to replace in-person interventions once the pandemic is over or whether things will return to “where we were prepandemic.”
Dr. Riper said she did not believe that clinicians will return completely to in-patient practice. However, she emphasized the need for training and the development of new skills to improve the therapeutic relationship with patients.
Although Dr. Riper believes there is still a need for in-person doctor/patient interactions, “we will never get back to the pre-COVID phase, both in terms of diagnostics and treatment,” she said.
Dr. Möller added that although he has “some reservations” regarding the adoption of technologies by older patients and the lack of long-term data on telepsychiatry, he partially shares Dr. Riper’s optimism.
He suggested that there is an opportunity in psychiatry to use video conferencing for multidisciplinary team meetings similar to those seen in oncology.
This would allow discussion of patient diagnosis and treatment and would enable experts in mental health to help clinicians in other specialties. For example, it could help a general practitioner differentiate between depression and a depressive phase of schizophrenia, Dr. Riper said.
The presenters have disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.