Evidence map›Paper›PMID 34753752›Full record

Trial reportBMJ open2021

Health providers' experiences with mental health specialist video consultations in primary care: a qualitative study nested within a randomised feasibility trial.

Markus W Haun, Mariell Hoffmann, Alina Wildenauer, Justus Tönnies, Michel Wensing, Joachim Szecsenyi, Frank Peters-Klimm, Regina Krisam, Dorothea Kronsteiner, Mechthild Hartmann and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Telemedicine as an Approach to the Mental Health of Healthcare Workers in Angola.International journal of environmental research and public health · 2025
    Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Markus W HaunDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany markus.haun@med.uni-heidelberg.de.ORCID 0000-0003-1851-3747
Mariell HoffmannDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Alina WildenauerDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Justus TönniesDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.ORCID 0000-0002-0308-8226
Michel WensingDepartment of General Practice and Health Services Research, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.ORCID 0000-0001-6569-8137
Joachim SzecsenyiDepartment of General Practice and Health Services Research, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Frank Peters-KlimmDepartment of General Practice and Health Services Research, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Regina KrisamInstitute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Dorothea KronsteinerInstitute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Mechthild HartmannDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.
Hans-Christoph FriederichDepartment of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Baden-Württemberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDespite available effective treatments for mental health disorders, few patients in need receive even the most basic care. Integrated telepsychiatry services may be a viable option to increase access to mental healthcare. The aim of this qualitative process evaluation embedded in a randomised controlled feasibility trial was to explore health providers' experiences with a mental healthcare model integrating mental health specialist video consultations (MHSVC) and primary care.

methodsA qualitative process evaluation focusing on MHSVC in primary care was conducted. In 13 semistructured interviews, we assessed the experience of all mental health specialists, primary care physicians and medical assistants who participated in the trial. A thematic analysis, focusing on the implementation, mechanisms of impact and context, was applied to investigate the data.

resultsConsidering (1) the implementation, participants evaluated the consultations as feasible, easy to use and time saving. Concerning (2) the mechanisms of impact, the consultations were regarded as effective for patients. Providers attributed the patients' improvements to two key aspects: the familiarity of the primary care practice and the fast access to specialist mental healthcare. Mental health specialists observed trustful therapeutic alliances emerging and described their experience as comparable to same-room care. However, compared with same-room care, specialists perceived the video consultations as more challenging and sometimes more exhausting due to the additional effort required for establishing therapeutic alliances. Regarding (3) the intervention's context, shorter travel distances for patients positively affected the implementation, while technical failures, that is, poor Internet connectivity, emerged as the main barrier.

conclusionsMHSVCs in primary care are feasible and successful in improving access to mental healthcare for patients. To optimise engagement and comfort of both patients and health providers, future work should focus on empirical determinants for establishing robust therapeutic alliances with patients receiving MHSVC (eg, leveraging non-verbal cues for therapeutic purposes). TRIAL REGISTRATION NUMBER: DRKS00015812; Results.

Indexed as

PsychiatryTelemedicineFeasibility StudiesHumansMental HealthPrimary Health CareReferral and ConsultationCOVID-19depression & mood disordersmental healthprimary carequalitative researchtelemedicine

Identifiers

PMID34753752
PMCPMC8578962

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.