Impact of Remote Appointments on the Outcomes of Community Mental Health Nurses in Primary Care Since the Covid Pandemic: A Retrospective Observational Cohort Study.

The move to remote working during the COVID-19 pandemic has remained an integral method of mental health service delivery. Yet there is a lack of evidence on the longer-term impact of this change, or on the comparative effectiveness of different remote formats. This retrospective observational cohort study examined the effect of the move to remote delivery on the effectiveness and practice of Community Mental Health Nurses in primary care. Data from 1634 referrals was examined across three cohorts: Those treated face-to-face pre-pandemic; those treated remotely during the pandemic restrictions; and those treated in a blended approach (remote and face-to-face) up to 16 months post-pandemic. Means, standard deviations and effect sizes for pre-post treatment change are reported for all clinical measures. Logistic regression examined predictors of reliable change. Despite increased severity in the mental health problems treated, effect sizes for remote treatment post-pandemic (0.5-0.8) were comparable to those for pre-pandemic face-to-face treatment (0.5-0.9). The blended use of online video appointments predicted better engagement and reliable improvement. The sole use of telephone appointments for complex problems predicted lower rates of engagement and improvement.