The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries.

To compare the efficacy of telepsychiatry and face-to-face treatment.

A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability.

We identified 32 studies (n = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders (k = 6 studies, n = 561; standardised mean difference s.m.d. = −0.325, 95% CI −0.640 to −0.011, P = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder (k = 1, n = 128; s.m.d. = 0.368, 95% CI 0.018–0.717, P = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 26, n = 2290; P = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment (k = 1, n = 61; risk ratio RR = 0.552, 95% CI 0.312–0.975, P = 0.040), whereas the opposite was seen for substance misuse (k = 1, n = 85; RR = 37.41, 95% CI 2.356–594.1, P = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 27, n = 3341; P = 0.564).

Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.

Italy was the first European country to face up with COVID-19 pandemic, which posed challenges to National Health System (NHS), including the need to adapt mental health services/infrastructures and implement digitalization.

Despite telepsychiatry (ie., delivery of psychiatric care remotely through IT), is extensively used in non-European countries, only during the COVID-19 pandemic, became a convincing alternative to face-to-face modality for many psychiatrists in their clinical practice. Our aim was investigating Italian psychiatrists’ opinion about telepsychiatry.

A questionnaire, disseminated during the third Italian phase, constituted by three sections (socio-demographic, opinions and personal experience about/with telepsychiatry) was build by adapting the 42-item questionnaire by Schubert (2019) and CAMH’s Client Experience Survey from the psychiatrist’s perspective.

90 questionnaires were collected from a sample of 54 women (60%) with an average age of 43(SD=11.4). Mostly were psychiatrists (85.6%) working in NHS (66.7%) with an average working years of 13.7(SD=11.5) and a previous experience in telepsychiatry (71.1%). Overall, participants do not believe that telepsychiatry is comparable with face-to-face modality. A significant positive opinion was reported among younger psychiatrists compared to those more experienced, regarding efficacy, feasibility and mental health access (p<0.05). No significant differences were reported in psychiatrists’ opinion, according to the level of telepsychiatry use in their clinical practice.

Overall, sufficient digital skills and knowledge of technological tools are evident among younger psychiatrists who also appeared to be more prone to implement telepsychiatry in their clinical practice.

No significant relationships.

European Federation of Psychiatric Trainees (EFPT) is a platform for psychiatric trainees from not only Europe but also various other countries. EFPT exclusively works on binding clinical practice and science for better mental health care. Research Working Group (RWG) of EFPT works on sharing knowledge with peers by brainstorming, collaborating and coordinating projects, organizing journal clubs and workshops.

We will focus on tele-psychiatry also known as e-mental health, a subdivision of telemedicine, provides diagnostic interview, evaluation, therapies, psycho-education and treatment. We plan The Brain-Drain follow-up study, investigates immigration of psychiatric trainees. Also educational activities have planned.

With a questionnaire on the topic of psychiatry residents’ acceptance of tele-psychiatry using The Unified Theory of Acceptance and Use of Technology (UTAUT), we will hold the first multi-national survey among psychiatry residents. The Brain-Drain study was conducted by the EFPT-RWG in the past had a promising outcome. We are currently working on the follow-up of the study. We are starting to hold events. For instance we will commence the monthly journal club. Apart from giving a platform for scientific debate, journal club will also provide a chance have a elaborate discussion with author. We will organize a workshop on how to write a case-study with Neuro-Psycho-Pharmacology Working Group of EFPT.

We assume diverse attitudes overlapping different telepsychiatry exposure and regualtions, comprehensive data on immigration of trainees and sharing knowledge on practice and research.

Hopefully, we will have clearer understanding of changes in working environment of trainees either with new technologies or in different countries.

No significant relationships.

The COVID epidemic has forced psychiatrists to introduce changes in outpatient clinics. A significant proportion of visits began without the patient’s face-to-face contact with the doctor. Are these visits stigmatized with a worse assessment of mental state? We know that much of the information flow takes place outside of verbal contact. In telephone contact, psychiatrists are limited to listening to the patient’s response and we know that non-verbal speech does not always go hand in hand with words.

The aim of the study is to compare face-to-face visits with a psychiatrist with outpatient visits by telephone in terms of changes in the treatment applied by psychiatrists.

The frequency of introducing changes in the current pharmacological treatment of patients was compared. Face-to-face visits to the outpatient clinic and visits where psychiatrists contacted patients via telephone were analyzed. Treatment change was defined as a reduction or increase in drug dose, drug discontinuation or the initiation of a new drug by a psychiatrist.

We assumed that visits without non-verbal contact do not provide as much information as direct visits. Consequently, patients who are often negative about the need to take medications over the phone will present themselves better to psychiatrists, thus the change in treatment will be used less frequently in this group. The results will be presented at the conference.

Currently, various forms of psychiatric care are evolving to adapt to new needs. We should also be aware of the consequences of these changes.

No significant relationships.

There is a significant psychiatry workforce shortage in Australia, particularly in rural and remote communities. Given the large distances involved, telehealth – providing consultation via videoconference – has been widely accepted. Psychiatrists were among the highest users of telehealth services in Australia before the COVID-19 pandemic. However, the outbreak of COVID-19 resulted in a major transformation to service delivery across Australia. Private psychiatrists and state public mental health services had to rapidly transition to largely telehealth delivery to ensure continuity of care for consumers.

In March 2020, additional telehealth item numbers were added to the Australian Medicare Benefits Schedule (MBS) to encourage physical distancing for those accessing medical services during the pandemic.

To provide an overview of the increase in telehealth activity since the COVID-19 pandemic.

The MBS is the list of services for which the Australian Government will pay a rebate. Key data on MBS telehealth activity since March 2020 was examined.

The use of telehealth has increased during the pandemic. A survey of Royal Australian and New College of Psychiatrists (RANZCP) psychiatrists found that 93% supported retention of telehealth MBS item number numbers following the COVID-19 pandemic, noting increased accessibility for consumers. Positive feedback has been received from consumers.

During 2020 and 2021, the RANZCP worked with the Australian Government to ensure there were appropriate MBS telehealth services available for consumers. The RANZCP continues to work with the Government as they plan for a longer-term transformation of telehealth services beyond 2021.

No significant relationships.

No significant relationships.

Telemedicine has been at the heart of healthcare system’s strategic response to the COVID-19 pandemic. Within psychiatry, there has been a surge of research and guidelines into the use of video-teleconferencing to replace face to face consultations across clinical settings. Clinical ward rounds are central to inpatient psychiatric care yet little guidance is available on how best to integrate telemedicine into the multidisciplinary work of inpatient psychiatry.

We report on the introduction of video teleconferencing for psychiatric ward rounds on our acute inner-London psychiatric unit during the outbreak of COVID-19.

In undertaking the rapid transition to tele-ward rounds, we had to reconcile the multiple functions of psychiatric ward rounds with the technological resources available to us.

Tele-ward rounds helped simplify care delivery, facilitate multidisciplinary collaboration and improve accessibility for patients and relatives in a time of crisis. The transition to tele-ward rounds also brought about technical, operational and communication issues that may impact on the patient experience and quality of care including governance challenges, contextual dissonance and technological limitations.

The routine use of newer technology in psychiatry ward rounds is unlikely to succeed on the basis of improvisation, particularly given the stream of technical innovations in telemedicine, and the multifarious quality of social interactions in our clinical setting. Staff training and the development of an adapted etiquette and code of communication are both essential. Patient participation in future developments will also help ensure tele-ward rounds continue to meet the standards of high quality inpatient psychiatric care beyond the COVID-19 pandemic.

No significant relationships.

The term “personalised therapy” refers to the use of genetic data to better treat or determine the predisposition to a specific genetic disease, with the ultimate goal of improving quality of life. Telepsychiatry and AI are key to support it..

Determine benefits of pharmacogenomic analysis (PGx) in CNS diseases regarding: - cost effectiveness - adverse drug reactions - reduced hospitalizations -drug interactions - efficacy - quality of life - “trial and error” approach avoidance

Questionnaires before and after the treatment provided using PGX tests Telepsychiatry for consultation along face to face sessions were conducted. Artificial intelligence in data analyses

Benefits of pharmacogenomic analysis (PGx) in CNS diseases: - cost effective savings - prediction and prevention of adverse drug reactions - reduced hospitalization due to ineffectiveness of medication - reduced risk of drug interactions - more effective treatments - better quality of life for the patient - with the analysis (PGx) the “trial and error” approach is avoided

In a number of studies in patients with mental disorders, pharmacogenomic analysis (PGx) has led to an increase in both clinical response and remission, better tolerated treatments, fewer side effects, and reduced treatment costs. In conclusion, pharmacogenomic analysis is ideal for patients with CNS diseases: a) Not responding to treatment b) Who in their history have many relapses and hospitalizations c) They show serious side effects d) Who do not comply with the treatment e) Taking many medications and suffering from serious illnesses f) Who are wary of taking psychotropic drugs

No significant relationships.

Telepsychiatry is the best-documented e-Mental Health application. It refers to the use of videoconferencing in the provision of mental health services. During the COVID19 pandemic, in response to physical distancing, mental health services worldwide have turned to online consultations. For the vast majority of clinicians, it was the first time they use telepsychiatry, and very few have received training in how to do it.

- to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry related to competencies & skills, educational & legislative needs, and international collaboration.

A structured review of the main challenges, innovations, and settings in the first Global Telepsychiatry Guidelines, published by WPA in February 2021.

The benefits of increased access to telehealth services are apparent for telepsychiatry, but benefits can only be realized if the tools are used by clinicians who have the appropriate training and guidance. With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills described in this document.

The need for training among health care professionals is the highest priority. The urgent need for clinical training and skills building around e-mental health inclusive telepsychiatry, will determine the influence that psychiatry can have in addressing the mental health sequelae of the COVID19 pandemic via competent practice and increased international collaboration.

I am the main author of “WPA Telepsychiatry Global Guidelines”

The COVID-19 pandemic led to the implementation of digital psychiatry (DP) in everyday clinical practice, resulting in the need for a skilled healthcare workforce.

Our purpose was to investigate the level of training, knowledge and expertise of young mental health professionals and medical students in DP, as well as exploring their beliefs and experiences in this field.

An ad hoc cross-sectional survey was designed and administered to Italian medical students, psychiatry trainees, and early career psychiatrists.

Most of the sample declared that the topic of DP was never discussed within their academic training (89.1%), mainly revealing an overall lack of knowledge on DP. Nevertheless, they mostly declared that DP represents a valuable therapeutic tool in mental health (80%) and that the academic background should include a dedicated course/module (54.4%). Moreover, most subjects declared that DP is less effective than in-person interventions (73.2%), despite the emerging evidence that being trained in DP is significantly associated with the belief that digital and in-person interventions are comparable in their effectiveness (p≤0.05).

During the current pandemic, DP represented an ideal response to the need for physical distancing by ensuring the advantage of greater access to care. However, DP interventions are still uncommon, and there remains a certain resistance to their use in mental health care. The lack of formal training during the academic training could be a limiting factor. Therefore, addressing these issues in academic settings could be crucial to spreading this innovative practice also in the post-COVID-19 era.

No significant relationships.

COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has been promoted as economical and effective, but its acceptance in low- and middle-income countries is poorly understood.

To explore the acceptance, experiences and perspectives of patients and healthcare providers in the uptake of telepsychiatry services in a middle-income country.

Focus group discussions were conducted on the WhatsApp platform with patients and care providers who have engaged in telepsychiatry. Data were analysed using a thematic approach.

Three main themes emerged from the five focus groups: (a) technical access, (b) user experience and (c) perceived effectiveness compared with face-to-face (in-person) interactions. Care providers reported challenges establishing rapport with the patient, particularly for initial sessions, maintaining privacy during sessions and detecting non-verbal cues on video. Patients cited internet connectivity problems, difficulty finding private space to have their sessions and cost as major challenges. Patients also felt in-person sessions were better for initial visits. Both patients and providers reported difficulties making insurance payment claims for telepsychiatry services. Overall, participants were mostly positive about telepsychiatry, citing its convenience and overall perceived effectiveness compared with in-person sessions.

Telepsychiatry is an acceptable platform for delivery of out-patient psychiatric services in a middle-income country. Patients and providers appreciate the convenience it offers and would like it integrated as a routine mode of delivery of care.

Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking.

We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak.

This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category.

We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10−3) as the number of face-to-face out-patient contacts significantly decreased (B = −0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders.

Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.

The mental health care system in Ukraine is centralized and largely focuses on capacity for inpatient psychiatric treatment with 90% of funding allocated to inpatient psychiatric care at hospitals, much higher than countries who already have more decentralized care. Community-based mental health care options, including mental health provided at the primary health care level are currently limited or absent in the mental health system. Psychosocial support, as well as self-care and mental health promotion are also insufficiently developed. Covid-19 pandemic is serious challenge for health care system, especially for consultation liaison psychiatry.

Mental health monitoring and psychological support in University Clinic of Kharkiv National Medical University, Ukraine during COVID-19 epidemic.

HADS, SCL-90, HDRS, HARS

During COVID-19 epidemic, implemented combination of off-line and eye-to-eye methods of mental health monitoring and psychological counselling for patients and medical staff in University clinic of Kharkiv National Medical University. Model of early detection and management of mental disorders based on multidisciplinary teamwork principles, сombination of off-line and eye-to-eye methods of screening, monitoring and psychological counselling for patients and medical staff. The online format proved beneficial because many patients of University clinic have trust issues and preferred not to deal with psychiatric services locally when it comes to mental health problems and it was accessible on epidemic conditions. An important part of the outreach work by the project was to destigmatize mental health problems.

Combined model (off-line and eye-to-eye services) of mental health care is preferred compare to traditional approach in modern conditions.