Faculty Bibliography

OBJECTIVE:A consortium of eight academic child and adolescent psychiatry programs in the United States and Canada examined their pivot from in-person, clinic-based services to home-based telehealth during the COVID-19 pandemic. The aims were to document the transition across diverse sites and present recommendations for future telehealth service planning. METHOD/METHODS:Consortium sites completed a Qualtrics survey assessing site characteristics, telehealth practices, service utilization, and barriers to and facilitators of telehealth service delivery prior to (pre) and during the early stages of (post) the COVID-19 pandemic. The design is descriptive. RESULTS:All sites pivoted from in-person services to home-based telehealth within two weeks. Some sites experienced delays in conducting new intakes and most experienced delays establishing tele-group therapy. No-show rates and utilization of telephony versus videoconferencing varied by site. Changes in telehealth practices (e.g., documentation requirements, safety protocols) and perceived barriers to telehealth service delivery (e.g., regulatory limitations, inability to bill) occurred pre/post-COVID-19. CONCLUSION/CONCLUSIONS:A rapid pivot from in-person services to home-based telehealth occurred at eight diverse academic programs in the context of a global crisis. To promote ongoing use of home-based telehealth during future crises and usual care, academic programs should continue documenting the successes and barriers to telehealth practice to promote equitable and sustainable telehealth service delivery in the future.

OBJECTIVE:This report summarizes findings from a 2020 survey of US child and adolescent psychiatry training programs that explored the impact of the COVID-19 pandemic on pediatric telepsychiatry training. The authors hypothesized that telepsychiatry training significantly increased during the pandemic, in part due to legal and regulatory waivers during the COVID-19 public health emergency. METHODS:In August 2020, an anonymous, 28-question online survey was emailed to all (138) accredited child psychiatry fellowships on the Accreditation Council for Graduate Medical Education website. Forty-nine programs responded (36%). This analysis focuses on three of the 28 questions relevant to the hypotheses: characteristics of the program's training in telepsychiatry; perceived impediments to clinical training; and perceived impediments to didactic training pre-COVID onset vs. post-COVID onset, respectively. Total scores were created to investigate differences in training programs and impediments to including telepsychiatry pre- and post-COVID onset. Paired sample t-tests were used to compare means pre- and post-COVID onset. RESULTS:Results provided support for significant differences between training components related to telepsychiatry pre- and post-COVID onset, with participants reporting more training components post-COVID onset (M = 5.69) than pre-COVID onset (M = 1.80); t(48) = 9.33, p < .001. Participants also reported significantly fewer barriers to providing clinical experiences in pediatric telepsychiatry post-COVID onset (M = 2.65) than pre-COVID onset (M = 4.90); t(48) =  - 4.20, p < .001. CONCLUSIONS:During the COVID-19 pandemic, pediatric telepsychiatry training in child psychiatry fellowships increased significantly. Perceived barriers to providing clinical, but not didactic, training decreased significantly.

Telepsychiatry is used to deliver care to children and adolescents in a variety of settings. Limited literature exists on telepsychiatry education and training, and the vast majority does not address considerations unique to practicing telepsychiatry with youth. Without relevant education, clinical experience, and exposure to technology, child and adolescent psychiatrists may be resistant to integrating telepsychiatry into their practice. Additional research is needed to assess the current state of telepsychiatry education and training in child and adolescent psychiatry fellowship programs.