The Catch-22 of Telehealth: A Qualitative Study of Its Dual Impact on the Work Experiences and Well-Being of Mental Health Professionals

Background and Purpose: Understanding the impact that telehealth services have on those working in the community mental health field is critical. The sudden and rapid shift to telehealth, brought on by the COVID-19 pandemic, has fundamentally altered how mental health services are delivered. This change has had a significant effect on mental health workers, including their work environment, productivity, well-being, and how they connect with their clients. Exploring the positive and negative effects of this transition can provide valuable insights into how telehealth can be optimized for the mental health professions and the clients they serve. It is important to identify strategies that support mental health workers as they adapt to this new mode of service delivery so we can ensure that the quality of care remains high while workers feel supported. The present study explores the positive and negative consequences that the shift to telehealth services during the COVID-19 pandemic had on those providing community mental health services.

Methods: The study utilized data from a cross-sectional survey conducted within a large Community Mental Health (CMH) organization in the Southwestern U.S. The focus was on a subset of providers (N = 112) who worked remotely from April to November 2020. Providers were asked about the impact remote work had on their work experience. The qualitative data were analyzed using a content analysis approach. Initially, five researchers reviewed transcripts independently, identifying preliminary themes and codes. A preliminary codebook was developed through consensus. After refining the codebook, two independent coders coded a random 50% of the data, with a third coder reviewing 30% of the coded responses for reliability. Overall, the coders demonstrated above-adequate interrater reliability (κ = .73), with a moderate level of agreement observed (90%). The coded responses were collaboratively synthesized into the major themes.

Results: The analysis revealed that telehealth implementation had both positive and detrimental effects on the working environment (adequate workspace/resources vs. inadequate workspace/resources in the home), productivity (greater work demands vs. fewer work distractions), work-life balance (more time to meet life demands vs. fewer boundaries between work and home life), well-being (more time for self-care vs. less), and social connection (more time for connection with family and friends vs. isolation from peers/colleagues), and client care (increased access vs. decreased access to clients).

Conclusion and Implications: This qualitative study highlights telehealth services' dual impact, revealing its benefits and drawbacks. Recognizing these aspects can help leaders and administrators make informed decisions regarding resource distribution (e.g., computer equipment), setting job expectations like productivity standards, and implementing work-life effectiveness strategies (e.g., flexible work schedules). Additionally, our research further indicates that telehealth facilitated more effective engagement with clients with technological proficiency and the means to receive telehealth services. Conversely, it was difficult to connect with clients who faced technological difficulties. These findings can guide us in creating telehealth services that enhance the benefits and minimize the drawbacks of telehealth, with the goal of ensuring that quality mental health services are provided while community mental health workers feel supported.