Video-confidence: a qualitative exploration of videoconferencing for psychiatric emergencies
Abstract
Background: In psychiatric emergencies in rural areas the availability of psychiatrists are limited. Therefore,
tele-psychiatry, via real-time videoconferencing (VC), has been developed to provide advanced consultative
services to areas that lack psychiatrists. However, there is limited research on the use of VC for psychiatric
emergencies. The University Hospital of North Norway has been the first hospital in Norway to implement this
type of service by developing a new on-call system for psychiatric emergency practice through which psychiatrists are
accessible by telephone and VC 24 hours a day for consultations with patients and nurses at three regional psychiatric
centres. This study explores patients’, psychiatrists’ and nurses’ experiences of using VC for psychiatric emergencies, as
well as how the technology influenced their confidence.
Methods: In this study, we used a qualitative explorative research design. With a particular focus on users’ experiences
of VC, we conducted 29 semi-structured interviews with patients, psychiatrists and nurses who had participated in a VC
consultation in at least one psychiatric emergency.
Results: Our findings show that access to the VC system increased the experience of confidence in challenging
psychiatric emergencies in four ways: (1) by strengthening patient involvement during the psychiatric specialist’s
assessment, (2) by reducing uncertainty, (3) by sharing responsibility for decisions and (4) by functioning as a safety net
even when VC was not used.
Conclusions: This study has demonstrated that an emergency psychiatric service delivered by VC may improve the
confidence of psychiatrists, nurses and patients in challenging psychiatric emergencies. VC can serve as an effective
tool for ensuring decentralised high-quality psychiatric services for emergency care.
Keywords: Psychiatry, Emergency care, Videoconferencing, Tele-psychiatry, Confidence, Qualitative study.