Lessons Learned from the Rapid Implementation of Telehealth Group Psychotherapy at a Safety-Net Health System in the U.S.

There is inadequate availability and access to behavioral health services to meet demand, and this issue amplified during the pandemic, creating a mental health crisis. Group therapy is an effective way to meet this need. The rapid implementation of telehealth group psychotherapy as part of a Primary Care Behavioral Health Integration program in a U.S. safety-net health care setting is described. Implementation lessons are summarized as barriers or facilitators, using thematic analysis of qualitative data from meeting notes. Major facilitators identified include having key staff serve as technology champions, dedicated administrative leadership to operationalize workflows, and communication and collaboration across teams and layers of infrastructure. Major barriers include uncertainty about operational workflows and technological challenges. While group visit volume initially waned, it began to rebound and quantitative analysis of demographic data shows that important underserved populations were reached. Frequent communication, collaboration, and adaptation among teams are critical elements for improving the likelihood of successful telehealth group therapy. It is feasible to expeditiously implement telehealth group psychotherapy in safety-net health care systems with limited resources.