New opportunities for interaction between mental health professionals and users
The COVID-19 pandemic forced us to abruptly and quickly change our way of thinking about mental health care, trying to make the best possible decisions under a lot of pressure.
As a general rule, the equipment and supplies of organizations dedicated exclusively to mental health are not designed or equipped by default to handle situations like those experienced. It was crucial to try to obtain personal protective equipment to protect both staff and staff. Those institutions that were able to anticipate what was coming gained invaluable time.
Nor was there time to design the adaptation to the new way of providing care and interacting in hospital settings. Equipping both professionals and patients with masks, maintaining social distancing, and implementing other hygiene and sanitation measures could have changed, as some of us thought, our professional-patient relationship. The patients, as so often before, as always, came to give us new examples of what it means to be resilient : hospitalized, doubly confined, unable to receive visitors, without outings… they collaborated in every setting, side by side with professionals, in caring for the environment and their own health. This is perhaps one of the main positive lessons we can learn from hospital mental health units.
What's here to stay? What has proven useful? Many of us, or at least most of us, immediately think of telehealth, which has allowed us to maintain a large part of outpatient care. Both the majority of professionals and users of the healthcare network have positively valued this way of interacting. While it has often been the only way to maintain the therapeutic connection during this period, there is unanimous agreement that the available tools have proven highly successful and have effectively compensated for the impossibility of in-person visits.
The scenario remains very uncertain and it is difficult to make hypotheses about how the coming months will unfold, as we approach autumn and winter, especially after having been able to confirm that the summer has not offered the much-desired complete respite.
Since June, much of the in-person activity has gradually resumed, and we are better at managing hygiene measures. What now should we do about telehealth? In my view, the future suggests that new agreements between professionals and users will be necessary, where it is hoped that we, as professionals, will not act from our historically paternalistic and protective stance, and that users will also allow themselves to be advised on occasion. Let me explain, and I ask myself: will those who have appreciated this form of in-person visits be able to choose to continue receiving care remotely? Who will ultimately decide how care is provided: the professional or the user? In crisis situations, will those resistant to in-person visits accept that this is the best way to receive outpatient treatment?
If telecare has proven its effectiveness (it should be remembered that during the strictest period of confinement there was no increase in visits to psychiatric emergency services, a key indicator that shows that assistance could be guaranteed in this emerging way in practically all territories), it is to be expected that we will be able to create hybrid systems that allow face-to-face and/or telematic care depending on the case , respecting the wishes of the users and their personal and health situation.
Technology, which we must once again be grateful for having existed these past months, will confront us with significant ethical dilemmas that may shape the future of mental health. It will be crucial for all stakeholders—scientific associations, people with lived experience, and their families—to define the new frameworks for interaction that may emerge from our experiences.
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