In their interesting paper, Wright and Caudill  highlight the importance of telemedicine
in the context of the COVID-19 pandemic. Although there were many barriers to telemedicine
, the unexpected worldwide COVID-19 pandemicrequired a rapid and tremendous pragmatic
turn to telepsychiatry in order to respond to treatment needs during the pandemic
[3, 4]. Currently, it is unclearwhether this innovation will move backwards or forwards
in the post-COVID-19 era and durably change the way to provide psychiatric care .
In an anonymous survey, we assessed to which extent patients (n = 1,732) and psychiatrists
(n = 27) of the area of the Mood Center Paris Saclay plan to continue with telepsychiatry
in the post-COVID era. The Mood Center Paris Saclay consultation unit provides general
psychiatric care with both biological and psychotherapeutic treatments for an area
comprising a part of the south of Paris downtown and its close suburbs. In this area,
14.3% of the inhabitants live below the poverty line, the unemployment rate is 12,
and 84.8% of the active individuals work in the tertiary sector (services). The mean
age of patients is 46 years, 57.1% are women, and their main primary diagnoses are
major depressive disorders, bipolar disorders, anxiety disorders, and substance use
disorders (mainly alcohol or tobacco). Whereas few teleconsultations were performed
before the COVID-19 pandemic in this Mood Center, all face-to-face consultations were
switched to teleconsultationson the first day of confinement in France. At the beginning
of de-confinement 2 months later, the expected continuation of telepsychiatry in the
post-COVID era was assessed. All psychiatrists responded to a questionnaire that gathered
information about their own preferences and individual data about their patients.
Since psychiatrists obtained data from their patients during the tele-consultations,
the percentage of response was high: 95% of the patients responded to the survey.
In the post-COVID era, 69% of the patients wish to continue with telepsychiatry (alternately
with face-to-face consultation or exclusively). Of note, patient wishes to continue
with telepsychiatry did not differ according to their demographics (age, gender, or
time needed to come to the consultation) and primary diagnoses.
The results of the survey show that 100% of the psychiatrists plan to continue with
telepsychiatry for 31% (CI95% [22.0–39.8]) of their consultations. There is no association
between both their years of practice and the perceived risk of COVID-19 and their
preference for face-to-face or distance-based services.
Psychiatrists indicate their preference for face-to-face consultation under each following
circumstance: for first-time consultations (81.8% of the psychiatrists), in case of
limited access to a private room (77.2% of the psychiatrists), potential severity
with a high risk of hospitalization (50% of the psychiatrists), and hearing loss (22.7%
of the psychiatrists).
After the pandemic, two-thirds of the patients wish to continue durably with telepsychiatry.
Moreover, all psychiatrists plan to continue with telepsychiatry for one-third of
their consultations. Our results show that patients may prefer telemedicine more than
their doctors. However, patients were not surveyed on reasons for wanting telemedicine.
However, it could be suggested that telemedicine is more convenient for patients than
for doctors, regarding travel time and cost savings. This point should be further
studied. Furthermore, it could be suggested that doctors may be resistant to a paradigm
shift and may see concerns that patients do not see, especially for severe patients
who could require inpatient treatment in the short term. Our results go beyond those
of a report published 15 years ago , which failed to show any difference in accuracy
and satisfaction between psychiatric face-to-face and teleconsultation.
Further studies should focus on the indications and contra-indications of telepsychiatry,
adequate longitudinal integration between face-to-face and teleconsultation, and the
efficiency and safety of the migration of care away from institutions with telepsychiatry.
Finally, our results suggest that COVID-19 may trigger a future widespread use of
Conflict of Interest Statement
The authors declare that they have no conflicts of interest to disclose.
This work received no funding.
R.C., A.E.K.A.T., D.D.L., E.S.-C., E. Corruble: conception and design of the study,
acquisition and analysis of data, drafting the manuscript, editing.
L.C., B.B., K.C., P.-A.L., F.G., R.M., S.R., A.R., S.Z., M.G., A.M., C.N., E. Chaneac,
S.M., W.C., P.H.: acquisition and analysis of data, editing.