Telehealth- should we or shouldn’t we?

Excerpts from our paper in Journal of Psychosocial research –

What Medium of Mental Health Services do Clients Prefer–Online or Offline? S Sharma, A Bahuguna. Journal of Psychosocial Research 17 (2), 451-466, 2022

In recent times, online counselling is being considered a cost-effective alternative for traditional face-to-face counselling especially helpful for those who are in remote areas and have no access to such services. The main objective of this research study is to understand the needs and attitudes of users when it comes to seeking mental health counselling services and what their preferences are between online counselling and face-to-face counselling. A survey is conducted with 203 users from age groups 16-40 years in India using Dr. Joseph Hammer’s Mental Health Seeking Attitude Scale and Aaron Rochlen’s online and face-to-face counselling attitudes scale. The results for the Joseph Hammer Scale show that users’ attitude towards seeking help from a mental health professional is positive- at least 71.4% consider it healthy, 63.1 % useful and 63.5% empowering. ANOVA is used to analyze the results of the Aaron Rochlen scale- it is observed that although the mean scores for preference face-to-faceface counselling are higher than those for online by approximately 25 percent, it can be concluded that the likelihood of people using online counselling is also encouraging given the statistics. For the question “It could be worthwhile to discuss my personal problems with a counselor” 95.1% agree with face-to-face counselling while 81.2% agree with online counselling. Based on these results, it seems like online counselling may be a good addition to face-to-face with regard to mental health services.

In the current times of lockdown and COVID 19, online counselling saw a surge in usage both from the practitioners and clients. In the present paper, we are looking into the mental health seeking attitude of the participants and the preferences they hold among face-to-face and online counselling. The authors included mental health seeking attitude keeping in mind the stigma psychotherapy or mental health treatment in any form holds in the Indian population. It is first necessary to understand if the participants are open to investing in counselling and then understand their preferences.

Mental health seeking attitude is basically an individual’s perception towards getting treatment for mental illness or other mental health issues. This attitude can be positive which indicates that if in need, the individual will readily take help from a mental health practitioner. However, if this attitude is negative, the individual might prefer to confide in family and friends or help themselves based on the ‘quick fixes’ given on the internet. In any situation these individuals would not reach out to a mental health practitioner to get better.

Face-to-face counselling is, as its name suggest, the traditional way of counselling where a counsellor and the counselee meet in a common physical setting and go through the process of counselling. Online counselling is when both the counsellor and the counselee connect on a virtual platform to initiate the therapeutic relationship. Both the types of counselling have their pros and cons and hence it completely depends on the individual’s preferences who are involved in the process.

This paper explores the mental health seeking attitude in Indian population and their preferences on face-to-face or online counselling. With this paper we aim to see if people are open to online counselling and what can be done to make online counselling smoother.

Different studies conclude that online counselling is either more effective or more preferred by individuals. The youth is primarily more inclined towards online counselling which is assumed to be because of their competence and comfort with technology and the internet.

Methodology-

Hypothesis:

1. There is a favourable attitude towards seeking mental health professionals in the Indian Population
2. Online counseling is preferred over Traditional counseling by the Indian population
3. Online counseling is as preferred as Traditional counseling
4. Traditional Counseling is preferred more than online counseling
5. There is a significant correlation between mental health seeking attitude and the preference for online or traditional counseling

Objectives:

1. To find the mental health seeking attitudes of the Indian population
2. To observe the preference of online counseling over traditional counseling
3. To observe the preference of traditional counseling over online counseling
4. To see if online counseling is as preferred as traditional counseling
5. To find the correlation between mental health seeking attitude and the preference for online or traditional counseling

Procedure

After the literature review was done, the authors finalized the materials to be used for the current study. The psychometric tests were then converted into an online google form and was circulated among the participants. The sample was selected with a convenience sampling method and 203 participants contributed to the study. Later, the quantitative analysis was carried out with the help of T-Test, Mean, Standard Deviation, and the calculations of P-values from the data.

Materials Used

Mental Health Seeking Attitude Scale

The Mental Health Seeking Attitude Scale (MHSAS) was developed by Dr. Joseph H. Hammer, Dr. Michael C. Parent, and Douglas A. Spiker. The instrument is a 9-item scale designed to measure the attitude of an individual towards seeking mental health treatment. This scale is available for free on drjosephhammer.com (Hammer et al., 2018).

Online & Face to Face Counselling Attitudes Scale

The Online & Face to Face Counselling Attitudes Scale was developed by Aaron B Rochlen, S. Natasha Beretvas, and Jason S. Zack in the year 2004. It is a 20 item scale which measures an individual’s preference towards online counselling and face-to-face counselling. The items are divided into two groups which measure the value of a counselling modality and the discomfort with the same modality. The authors have provided the instrument and the instructions of the same in their paper (Rochlen et al., 2004).

Results

Results for a survey of 203 participants responding to a Joseph Hammer questionnaire showed that most people considered it healthy, useful and empowering to seek help from a mental health professional.

Results indicated an overall positive attitude towards seeking professional help for mental health counselling – online and face to face; as well as showed a slight preference towards face-to-face counselling as compared to online counselling. It was observed that people largely have a favorable mental health-seeking attitude with at least 63% finding it useful, important, and healthy. It was seen that people had a favorable attitude towards both online and face-to-face counselling even though they favored face-to-face counselling more by approximately 25%. It seems like there is a correlation between favorable mental health-seeking attitudes and a favorable attitude towards online and face-to-face counselling implying that those who consider it healthy to get professional mental help when needed will seek face-to-face or online counselling as and when needed.