Background and Purpose:
Mental health issues affect an estimated 20 percent of the North American population and are significant contributors to the burden of disease worldwide. While many evidence-based treatment approaches exist, global access to mental health care remains a challenge. E-mental health, commonly referred to as virtual mental health, has emerged in recent years as a means of increasing access to mental health care through the use of information and communication technology, demonstrating tremendous potential to advance service access and reduce barriers to care. Given the rapid increase in e-mental health research and subsequent increase in literature reviews, the current study
used a scoping review of reviews (SRR) to provide a synthesis of the e-mental health research literature, with a specific focus on how the literature maps onto the Institute of Medicine’s (IOM) six domains of health care quality: Safe, Effective, Patient-Centered, Efficient, Timely, and Equitable. Using the six domains of health care quality as a guiding framework, this SRR sought to answer the following research questions: 1) What is the current state of the literature with respect to e-mental health services? 2) How does the literature map onto health care quality domains of Safe, Effective, Patient-Centered, Efficient, Timely, and Equitable? 3) What are the strengths and limitations of the current e-mental health research literature? and 4) What dimensions of health care quality would benefit from further research and evaluation?
Methods: Using the methodological framework outlined by Arksey & O’Malley, adapted for an SRR, this review followed a five stage process: 1) clarify the scope and develop research questions; 2) identify studies through a search process; 3) select studies; 4) chart the data; and 5) summarize and report the results. Studies were identified using the following databases: PsycINFO, Medline, Embase, and Social Work Abstracts to ensure broad representation of literature across mental healthcare sectors, including social work, medicine, nursing and psychology.
Results: 395 articles were retrieved in the database searches, with 106 meeting eligibility for inclusion in the final analysis following title and abstract, as well as full text reviews. 78% (n=83) of the review articles were published in the last five years, demonstrating a growing interest in this area. Results from the SRR are presented narratively, as well as in charts and summary tables to illustrate how each of six health care quality domains were specifically addressed.
Conclusions and Implications: Given the rapid increase in e-mental health research in recent years, this SRR is well timed to provide a synthesis of the literature. By mapping the literature across the IOMs well-established six domains of health care quality, this SRR identified strengths and opportunities for further research, and outlined targeted recommendations to inform research, policy and practice in this burgeoning area.