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Gaps in Detection: Comparing Provider- and Client-Reported Indicators of Engagement in Youth Telemental Health
Eleanor G Wu1, Kimberly D Becker1, Benjamin M Isenberg2
1Department of Psychology, University of South Carolina.
Summary
Providers often miss low engagement in telemental health (TMH) services, particularly for relationship-focused aspects. Multidimensional surveys can help detect these issues for better intervention.
Area of Science:
- Mental Health
- Digital Health
- Clinical Psychology
Background:
- Telemental health (TMH) services present unique challenges for assessing patient engagement.
- Early detection of engagement problems is critical for timely intervention and improved outcomes.
Purpose of the Study:
- To examine how providers detect low engagement in TMH, both overall and across specific dimensions.
- To understand how providers characterize high and low engagement in active TMH cases.
Main Methods:
- A survey assessed engagement dimensions in 153 youth/caregivers receiving TMH.
- School-based providers (N=49) reported on engagement indicators for their cases.
- Provider-reported indicators were qualitatively coded across five engagement dimensions.
Main Results:
- Nearly 40% of cases showed low engagement via self-report, but 79% were missed by providers.
- When providers detected low engagement, their indicators matched self-reports only 23% of the time.
- Low engagement was better detected for participation (attendance, homework) than process (relationship, expectancy) dimensions (p=.004).
Conclusions:
- Providers are less consistent in identifying low engagement in TMH, especially for process-oriented dimensions.
- Multidimensional engagement surveys may improve early detection and intervention for engagement concerns in TMH.
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