Welcome to the 21st WCP Virtual Congress Program Scheduling

Objectives

The use of Telepsychiatry has significantly increased as many regulatory barriers to its use have been temporarily lowered during the COVID-19 pandemic.

We will:

-outline temporary changes in TP regulations due to COVID19;

-discuss which of these should be maintained, modified, or reversed;

-propose further initiatives needed to facilitate to be better prepared for future unprecedented events.

Methods

- Outline of the pre-COVID19 status related to the use of technology in mental health care provision.

- Examination and outline of the use of TP in the light of regulatory- and clinical practicing changes made due to COVID19.

Results

The most important policy change is the removal of the “originating site” rule so professionals can be paid for a remote appointment wherever the patient is, including in the patient’s home. In addition, mental health providers were allowed to serve patients through everyday communication technologies such as FaceTime, Viber, or Skype regardless of their non-efficient security settings that threaten the patient's data security. At the same time, the clinicians were provided TP without the necessary training related to competencies and skills.

Conclusions

WPA is perfectly positioned to be the frontrunner for required changes i.e.

1) implementation of faculty development incl. mandatory lectures related to eMH at medical educational institutions,

2) TP-competency training of mental health professionals,

3) promotion of WPA Global TP Guidelines,

4) collaboration with policymakers regarding regulatory and statutory changes i.e. unified licensure regulations, etc that are crucial for modernizing mental health care delivery and preparation for future unprecedented events.

Objectives

Regulatory constraints in combination with clinicians' concerns related to data safety, reimbursement, quality of practice, lack of experience with the use of technology, and difficulties in changing daily routines have kept telepsychiatry from being widely adopted and implemented prior to the current pandemic. Accordingly, the pandemic time for the vast majority of clinicians is the first time they use telepsychiatry, and very few have received training in how to do it. That is why a need for global guidelines and unified standardizations is of utmost importance in this rapidly growing but not yet well-established field. By mastering telepsychiatry, we may enable the remote provision of the majority of e-Mental Health approaches complementary to our traditional service(s). However, first, we ought to become familiar with its basics.

Methods

A structured review of the main challenges, innovations, and settings in the first global guidelines on telepsychiatry, published by WPA.

Results

Certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills described in this document.

Conclusions

WPA Telepsychiatry Global Guidelines may pave the way for the development of global regulations in order to break down the barriers of accessibility for both the professionals as well as for the patients worldwide. Further, it may help professionals in setting up a standardized telepsychiatry service(s) in addition to the existing mental health system(s).

Objectives

Smartphone-based devices are increasingly recognized to assess disease symptoms (e.g. ecological momentary assessment, EMA). Despite this development in digital psychiatry, clinical trials are mainly based on point assessments of psychopathology. This study investigated expectable increases in statistical power by intense assessment.

Methods

A simulation study, based on three scenarios and several empirical data sets, estimated power gains of two- or fivefold pre-post-assessment. For each condition, data sets of various effect sizes were generated, and AN(C)OVAs were applied to the sample of interest (N=50–N= 200).

Results

Power increases ranged from 6% to 92%, with higher gains in more underpowered scenarios, and with higher number of repeated assessments. ANCOVA profited from a more precise estimation of the baseline covariate, resulting in additional gains in statistical power. Fivefold pre-post EMA resulted in highest absolute statistical power and clearly outperformed traditional questionnaire assessments. For example, ANCOVA of automatized PHQ-9 questionnaire data resulted in absolute power of 55 (for N = 200 and d = 0.3). Fivefold EMA, however, resulted in power of 88.9. Non-parametric and multi-level analyses resulted in comparable outcomes.

Conclusions

Besides providing psychological treatment, digital mental health can help optimizing sensitivity in RCT-based research. Intense assessment appears advisable whenever psychopathology needs to be assessed with high precision at pre- and post-assessment (e.g. small sample sizes, small treatment effects, or when applying optimization problems like machine learning). First empiric studies are promising, but more evidence is needed. Simulations for various effects and a short guide for popular power software are provided for study planning.

Objectives

On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization. In response to the sudden rise in COVID-19-related mental health and psychosocial impacts, we embarked on a digital training (e-learning) and remote delivery adaptation for Problem Management Plus Training for Helpers (Remote PM+ Training) based in New York City, four European countries and six African countries. This presentation provides an overview of the two Remote PM+ Trainings, including key adaptations and lessons learned across the contexts.

Methods

Trainings were approximately 75 hours in duration, with a mix of group and individual work, in diverse contexts. Overall, remotely delivered PM+ training and intervention appear appropriate.

Results

There were a number of critical lessons learned that contributed to the efficacy of the trainings, such as technological support, digital literacy, preparation and flexibility among the trainers and the trainees. There is also a need for cultural and contextual adaptation towards the delivery of remote training and implementation of PM+.

Conclusions

The outcomes from these two trainings indicate that PM+ may be adapted for remote (online) training and, if supported with additional studies, could build workforce capacity in contexts in which there is limited in-person access to mental health and psychosocial support services and staff. PM+ has become a critical tool to bridge this gap in mental health service accessibility and to bring learnings on task-sharing to help address mental health inequities in diverse contexts. As a capacity building tool, remote PM+ and may reduce barriers in contexts when in-person delivery is not feasible.