Experiences of Mental Health Professionals in the Rapid Pivot to Telehealth

Implications for Social Work Practice


  • W. Patrick Sullivan Indiana University
  • Carol Hostetter Indiana University
  • Miriam Commodore-Mensah Indiana University




COVID-19, social work, community mental health, telehealth


During the COVID-19 pandemic, the adoption of telehealth in behavioral healthcare was rapidly accepted. This article reflects one component of a larger qualitative study that sought to understand the personal and professional experiences of front-line workers and their supervisors during the pivot to virtual services during the COVID-19 pandemic. The current article is focused on the question, what were mental health workers’ reactions, both personal and professional, to the rapid adoption of technology in their community mental health center practice? Thirty-six mental health professionals, ranging from front line workers to supervisors, participated in telephone and Zoom interviews between late August and mid-November 2020. Respondents spoke of their organization’s rapid response, the switch to telehealth for many services, the impact of this switch on professional practice, and their perceptions of the effectiveness of virtual services. They also shared their thoughts about the future of telehealth. The rapid changes, necessary for clients and the organization alike, brought an opportunity to reimagine service delivery. As social work is a profession that heavily emphasizes ethics and advocacy, and is the predominant professional group in community mental health, the final section examines implications for social work practice including practice ethics, consideration of factors on a micro, macro, and environmental level, the need to balance protection of the individual with the rights of many, and the necessity to take care of those doing the work as well.

Author Biography

Carol Hostetter, Indiana University

Social Work Associate Professor


American Board of Clinical Social Work. (2023, February 1). What is clinical social work? https://www.abcsw.org/what-is-clinical-social-work#:~:text=With%20250%2C000%20practitioners%20serving%20millions,healthcare%20providers%20in%20the%20nation

Ashcroft, R., Donnelly, C., Dancey, M., Gill, S., Lam, S., Kourgiantakis, T., Adamson, K., Verrilli, D., Dolovich, L., Kirvan, A., Mehta, K., Sur, D., & Brown, J. B. (2021). Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: A qualitative study. BMC Family Practice, 22(1), 1-12. https://doi.org/10.1186/s12875-021-01496-8

Bakker, A. B., & van Woerkom, M. (2018). Strengths use in organizations: A positive approach of occupational health. Canadian Psychology/Psychologie Canadienne, 59(1), 38-46. https://doi.org/10.1037/cap0000120

Banks, S., Cai, T., De Jonge, E., Shears, J., Shum, M., Sobočan, A. M., Strom, K. Truell, R., Uriz, M. J., & Weinberg, M. (2020). Practising ethically during COVID-19: Social work challenges and responses. International Social Work, 63(5), 569-583. https://doi.org/10.1177%2F0020872820949614

Bashshur, R. L., Shannon, G. W., Bashshur, N., & Yellowlees, P. M. (2016). The empirical evidence for telemedicine interventions in mental disorders. Telemedicine and e-Health, 22(2), 87-113. https://doi.org/10.1089/tmj.2015.0206

Billings, J., Abou Seif, N., Hegarty, S., Ondruskova, T., Soulios, E., Bloomfield, M., & Greene, T. (2021). What support do frontline workers want? A qualitative study of health and social care workers’ experiences and views of psychosocial support during the COVID-19 pandemic. PLoS One, 16(9), 1-24. https://doi.org/10.1371/journal.pone.0256454

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Crockett, J. L., Becraft, J. L., Phillips, S. T., Wakeman, M., & Cataldo, M. F. (2020). Rapid conversion from clinic to telehealth behavioral services during the COVID-19 pandemic. Behavior Analysis in Practice, 13(4), 725-735. https://doi.org/10.1007/s40617-020-00499-8

de Jonge, E., Kloppenburg, R., & Hendriks, P. (2020). The impact of the COVID-19 pandemic on social work education and practice in the Netherlands. Social Work Education, 39(8), 1027-1036. https://doi.org/10.1080/02615479.2020.1823363

Dima, G., Meseșan Schmitz, L., & Șimon, M. C. (2021). Job stress and burnout among social workers in the VUCA World of COVID-19 pandemic. Sustainability, 13(13), 7109-7134. https://doi.org/10.3390/su13137109

Dominelli, L. (2021). A green social work perspective on social work during the time of COVID‐19. International Journal of Social Welfare, 30(1), 7-16. https://doi.org/10.1111/ijsw.12469

Funk, K. (2021). The last mile: COVID-19, telehealth, and broadband disparities in rural Indiana. Advances in Social Work, 21(1), 45-58. https://doi.org/10.18060/24844

Gentry, M. T., Puspitasari, A. J., McKean, A. J., Williams, M. D., Breitinger, S., Geske, J. R., Clark, M. M., Moore, K. M., Frye, M. A., & Hilty, D. M. (2021). Clinician satisfaction with rapid adoption and implementation of telehealth services during the COVID-19 pandemic. Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association, 27(12), 1385-1392. https://doi.org/10.1089/tmj.2020.0575

Golightley, M., & Holloway, M. (2020). Social work in the time of the COVID-19 pandemic: All in this together? British Journal of Social Work, 50(3), 637-641. https://doi.org/10.1093/bjsw/bcaa036

Haque, S. N. (2021). Telehealth beyond COVID-19. Psychiatric Services, 72(1), 100-103. https://doi.org/10.1176/appi.ps.202000368

Heisler, E. J., & Bagalman, E. (2013). The mental health workforce: A primer. https://sgp.fas.org/crs/misc/R43255.pdf

Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine and E-Health, 19(6), 444-454. https://doi.org/10.1089/tmj.2013.0075

Jeffrey, J., Marlotte, L., & Hajal, N. J. (2020). Providing telebehavioral health to youth and families during COVID-19: Lessons from the field. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S272-S273. https://psycnet.apa.org/doi/10.1037/tra0000817

Lin, L. A., Fernandez, A. C., & Bonar, E. E. (2020). Telehealth for substance-using populations in the age of coronavirus disease 2019: Recommendations to enhance adoption. JAMA Psychiatry, 77(12), 1209-1210. https://doi.org/10.1001/jamapsychiatry.2020.1698

Litam, S. D. A., Ausloos, C. D., & Harrichand, J. J. (2021). Stress and resilience among professional counselors during the COVID‐19 pandemic. Journal of Counseling & Development, 99(4), 384-395. https://doi.org/10.1002/jcad.12391

Lowden, R. J., & Hostetter, C. (2012). Access, utility, imperfection: The impact of videoconferencing on perceptions of social presence. Computers in Human Behavior, 28(2), 377-383. https://doi.org/10.1016/j.chb.2011.10.007

Maese, J. R., Seminara, D., Shah, Z., & Szerszen, A. (2020). Perspective: What a difference a disaster makes: The telehealth revolution in the age of COVID-19 pandemic. American Journal of Medical Quality, 35(5), 429-431. https://doi.org/10.1177%2F1062860620933587

Medalia, A., Lynch, D. A., & Herlands, T. (2020). Telehealth conversion of serious mental illness recovery services during the COVID-19 crisis. Psychiatric Services, 71(8), 872-872. https://doi.org/10.1176/appi.ps.71705

Miglianico, M., Dubreuil, P., Miquelon, P., Bakker, A. B., & Martin Krumm, C. (2020). Strength use in the workplace: A literature review. Journal of Happiness Studies 21, 737-764. https://doi.org/10.1007/s10902-019-00095-w

Miller, J. J., Barnhart, S., Robinson, T. D., Pryor, M. D., & Arnett, K. D. (2021). Assuaging COVID-19 peritraumatic distress among mental health clinicians: The potential of self-care. Clinical Social Work Journal, 49, 505-514. https://doi.org 10.1007/s10615-021-00815-x

Mishkind, M. C., Shore, J. H., & Schneck, C. D. (2021). Telemental health response to the COVID-19 Pandemic: Virtualization of outpatient care now as a pathway to the future. Telemedicine and e-Health, 27(7), 709-711. https://doi.org/10.1089/tmj.2020.0303

Mishna, F., Milne, E., Bogo, M., & Pereira, L. F. (2021). Responding to COVID-19: New trends in social workers’ use of information and communication technology. Clinical Social Work Journal, 49(4), 484-494. https://doi.org/10.1007/s10615-020-00780

Mochari-Greenberger, H., & Pande, R. (2021). Behavioral health in America during the COVID-19 pandemic: Meeting increased needs through access to high quality virtual care. American Journal of Health Promotion 35(2), 312-317. https://doi.org/10.1177%2F0890117120983982d

Morse, G. A., & Dell, N. A. (2021). The well-being and perspectives of community-based behavioral health staff during the COVID-19 pandemic. Social Work in Health Care, 60(2), 117-130. https://doi.org/10.1080/00981389.2021.1904315

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1). https://doi.org/10.1177/1609406917733847

Oesterle, T. S., Kolla, B., Risma, C. J., Breitinger, S. A., Rakocevic, D. B., Loukianova, L. L., Hall-Flavin, D. K., Gentry, M. T., Rummans, T. A., Chauhan, M., & Gold, M. S. (2020). Substance use disorders and telehealth in the COVID-19 pandemic era: A new outlook. Mayo Clinic Proceedings, 95(12), 2709-2718. https://doi.org/10.1016/j.mayocp.2020.10.011

Redondo-Sama, G., Matulic, V., Munté-Pascual, A., & de Vicente, I. (2020). Social work during the COVID-19 crisis: Responding to urgent social needs. Sustainability, 12(20), 1-16. https://doi.org/10.3390/su12208595

Rogers, E. (2003). The diffusion of innovations (5th ed.). Free Press.

Sasangohar, F., Bradshaw, M. R., Carlson, M. M., Flack, J. N., Fowler, J. C., Freeland, D., Head, J., Marder, K., Orme, W., Weinstein, B. Kolman, J. Kash, B., & Madan, A. (2020). Adapting an outpatient psychiatric clinic to telehealth during the COVID-19 pandemic: A practice perspective. Journal of medical Internet research, 22(10), e22523. https://doi.org/10.2196/preprints.22523

Tse, J., LaStella, D., Chow, E., Kingman, E., Pearlman, S., Valeri, L., Wang, H., & Dixon, L. B. (2021). Telehealth acceptability and feasibility among people served in a community behavioral health system during the COVID-19 pandemic. Psychiatric Services, 72(6), 654-660. https://doi.org/10.1176/appi.ps.202000623

Walter-McCabe, H. A. (2020). Coronavirus pandemic calls for an immediate social work response. Social Work in Public Health, 35(3), 69-72. https://doi.org/10.1080/19371918.2020.1751533

Weick, A., Rapp, C., Sullivan, W. P., & Kisthardt, W. (1989). A strengths perspective for social work practice. Social work, 34(4), 350-354. https://doi.org/10.1093/sw/34.4.350

Wilkerson, D. A., Wolfe-Taylor, S. N., Deck, C. K., Wahler, E. A., & Davis, T. S. (2020). Telebehavioral practice basics for social worker educators and clinicians responding to COVID-19. Social Work Education, 39(8), 1137-1145. https://doi.org/10.1080/02615479.2020.1807926

Yellowlees, P., Nakagawa, K., Pakyurek, M., Hanson, A., Elder, J., & Kales, H. C. (2020). Rapid conversion of an outpatient psychiatric clinic to a 100% virtual telepsychiatry clinic in response to COVID-19. Psychiatric Services, 71(7), 749-752. https://doi.org/10.1176/appi.ps.202000230