Mental Health Care Guidelines for Telemedicine During the COVID-19 Pandemic: Scoping Review

Mental health care providers have widely adopted telemedicine since the onset of the COVID-19 pandemic. Some providers have reported difficulties in implementing telemedicine and are still assessing its sustainability for their practices. Recommendations, best practices, and guidelines for telemedicine-based mental health care (ie, telemental health care [TMH]) have been published, but the nature and extent of this guidance have not been assessed.

We aimed to determine (1) the form of TMH guidelines and recommendations presented to providers, (2) the most commonly presented recommendations and guidelines, and (3) the perceived benefits and challenges of these TMH guidelines and recommendations.

Through our scoping review of practice guidelines, we aimed to identify themes in TMH guidelines and clinical recommendations published between 2020 and 2024 in peer-reviewed journals. This review focused on the first 2 years of the COVID-19 pandemic to identify and characterize the available TMH guidance. We searched PubMed/MEDLINE and ScienceDirect for articles in peer-reviewed journals published between January 1, 2020, and July 16, 2024. We included articles that were available in English and presented recommendations, best practices, or guidelines for TMH. We excluded duplicates, articles unrelated to telehealth, brief editorial introductions, and those not publicly available. We applied the Healthcare Provider Taxonomy of the National Uniform Claim Committee to article titles and abstracts to identify records relevant to mental health. We used content and thematic analyses to identify key themes.

Of the 1348 articles retrieved, we identified 76 that matched our criteria. Through content and thematic analyses, we identified 3 main themes-along with subthemes and topics-related to Facilitators, Concerns, and Changes Advised. The majority of articles called for further research (59/76) and for telemental health education and innovation in some form (43/76) regarding advised changes. Twenty-four articles included specific guidelines, recommendations, or checklists for providers.

The results highlight the need for further large-scale research to support the development of effective guidelines and protocols for therapy plans. Although TMH care is widespread, scholarly work emphasizes the need for a stronger evidence base that includes testing protocols in diverse settings and populations. The results also underscore the importance of increasing health professionals' knowledge of regulatory compliance and providing them with adequate TMH practice education.