The 2019 coronavirus disease (COVID-19) pandemic has underscored the need for increasing access to telepsychiatry services among older adults. However, numerous barriers threaten to leave this population out of reach. Proposed guidelines published in the American Journal of Psychiatry may offer clinicians ways to facilitate technology use in this population.

Older adults who might be at higher risk for developing more serious complications from COVID-19 also face risk factors such as loneliness, social isolation, and subsequent depression. Internet-delivered cognitive behavioral therapy has been shown to reduce anxiety and depression in older adults, and new mobile apps that support self-care and overall mental health, such as the COVID Coach app from the US Department of Veterans Affairs, may hold promise. However, apps are rarely tested in this population, and evidence is lacking more broadly. Many older adults may lack access to or awareness of available mental health apps.  

Christine E. Gould, PhD, of the department of psychiatry and behavioral sciences, Stanford University School of Medicine, Palo Alto, California, and colleagues developed recommendations to expand access to technology, promote technology literacy, increase patient buy-in, and help older adults become familiar with new tools.

The research team stresses that reduced cost, as well as free home broadband or mobile devices with data plans, are essential to improving access. They recommended that clinicians locate local programs that facilitate technology access for low-income individuals. To promote technology literacy, clinicians can ask patients questions such as: “Do you have a smartphone? Do you have Wi-Fi at home? Have you downloaded an app? Do you use FaceTime [or other video chat apps]?”


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“The recommendation should encompass both the usefulness of the tool and its usability, which comprise two critical aspects underlying technology adoption,” noted the researchers. The team also recommends promoting technology use to stay active, manage anxiety, and cope with social isolation. When offering information, clinicians should explain why the app, video conferencing tool, or other technology is useful and take the time to get to know the recommended tool before suggesting it.

“Clinicians can help span these gaps by asking questions, providing assistance, and teaching about free, evidence-informed interventions that may be used to manage mental health symptoms on one’s own or with guidance,” the researchers stated, “COVID-19 highlights that technology access and literacy are unexpected and crucial aspects of disaster preparedness.”

Reference

Gould CE, Hantke NC. Promoting technology and virtual visits to improve older adult mental health in the face of COVID-19 [published online May 15, 2020]. Am J Geriatr Psychiatry. doi:10.1016/j.jagp.2020.05.011