Client, Clinician, and Administrator Factors Associated with the Successful Acceptance of a Telehealth Comprehensive Recovery Service: A Mixed Methods Study

The coronavirus disease 2019 SARS-CoV-2 (COVID-19) crisis and subsequent social distancing recommendations resulted in increased use of telehealth within recovery-oriented behavioral health services (RS). Populations with serious mental illness (SMI) rely on psychosocial treatment, care coordination, and pharmacotherapy to achieve recovery goals and increase community engagement. This program evaluation of a group-based RS used mixed methods to better understand the multiple factors that contributed to successful telehealth conversion. Clients' service utilization over an 18-week period was collected to determine acceptance and the client characteristics associated with utilization (n = 72). Clients completed a treatment satisfaction questionnaire that was distributed ten weeks following telehealth conversion. Qualitative interviews explored staff perspectives on factors that impacted conversion, acceptance, and utilization. Initial staff skepticism gave way to acceptance, while the demands of resourcefulness, flexibility, and competency were emphasized. Clients' treatment utilization remained stable, while the number of missed/cancelled sessions were less frequent over time, especially for clients with a history of psychosis. Clients reported high overall satisfaction, but a preference for in-person treatment. Within this clinic serving middle to high socioeconomic status (SES) clients, clinicians and clients alike found the virtual group-based RS to be feasible and acceptable while in-person treatment was not an option.