One of the most noticeable shifts in mental health care since 2020 has been the exponential increase in telehealth service delivery. The forced shift to telehealth exposed differing preferences between practitioner disciplines for telephone vs. video telehealth technologies. This article will summarize these differences and make related recommendations for telehealth expansion in the future.
History of Research: Telephone vs. Video Telehealth
Previous studies suggest that video telehealth might be superior to phone consultations, as the literature supporting this preference had been stronger than telephone interventions (Luxton, Nelson, Maheu, 2016, Glueukauf, Maheu, Drude, Wells, Wang, Gustafson, 2018). Video telehealth sessions can offer a richer communicative experience, making it easier to understand a person’s intent by offering body language, facial expressions, and other non-verbal cues possible. Video capabilities also allow the professional to access more information about the surrounding environment of the client or patient, including whether other people might be in the immediate environment. This additional visual information can lead to more accurate diagnosis and treatment while providing extra assurance of the lack of coercion or intrusion by other parties in the client’s environment. However, not all providers may fully take advantage of this potentially superior option.
Telephone vs. Video Clinician Preference
A recent study by Connolly and colleagues examined discipline-level differences in mental health provider perceptions of telephone and video telehealth during COVID-19 (2023). Published in Psychological Services, the study found evidence of a notable discrepancy between the use of audio and video telehealth between medical mental health providers (such as psychiatrists) and nonmedical providers (such as psychologists). The findings suggest that psychiatrists prefer phone consultations, while other mental health clinicians prefer video sessions.
The authors queried 414 study participants by using a survey examining the perception and experience of these two groups toward using telephone and video telehealth. A 32-item survey included items related to care quality, factors contributing to the choice of communication modality, and the challenges of telehealth. It received a 79.5% response rate. The type of visits each provider had completed in the months before the survey was also scrutinized using administrative data. Researchers sought to understand perceptions of medical vs nonmedical providers.
Based on their survey findings, the researchers suggested the following to be true:
- Medical and nonmedical providers generally found video consultations to be higher quality than phone consultations.
- When choosing between video and phone consultations, nonmedical providers were more influenced by research demonstrating the superior effectiveness of video consultations.
- Medical providers reported more challenges with video consultations, citing patients’ technical difficulties and the need for more patient education.
The administrative data corroborated the survey responses, which showed the following:
- Medical providers conducted fewer video consultations than nonmedical providers. The researchers suggested that this could possibly be attributed to a lower awareness among medical providers of the research evidencing the effectiveness of video consultations. Another possible barrier might be the perceived complexity of video visits.
Recommendations by the researchers encourage a higher uptake of video consultations among medical providers. Streamlining the video consultation process and providing increased technical support could mitigate some of the reported challenges.
Increased professional development may be more readily available. In addition, disseminating research or offering professional development opportunities that objectively compare the quality of video and phone consultations may help promote a better understanding of video telehealth’s benefits for clinicians in behavioral services.
To help educate patients and clients, many video conferencing companies offer consumer-facing patient tutorials for using video conferencing software. Health and Human Services (HHA) also makes client and patient education about telehealth available at no cost, with easy-to-understand webpages that explain the process in English and Spanish. More specific instruction for introducing telehealth to behavioral health clients and patients is also available.
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