Digital health services and their application in mental healthcare
A literature review
DOI:
https://doi.org/10.14528/snr.2026.60.Suppl.1.3335Keywords:
service accessibility, telepsychiatry, telemedicine, technology, nursesAbstract
Introduction: Telemedicine services have become increasingly widespread in health care, particularly since the COVID-19 pandemic. As mental health disorders represent a significant public health challenge, digitalisation offers opportunities to improve access and quality of care. The aim of telemedicine is to provide safe, accessible, and effective health care.
Methods: An integrative literature review was conducted, which included scientific articles published between 2010 and 2025 in the Medline, PubMed, CINAHL, Google Scholar, and Elsevier databases. Search strings in both Slovenian and English were used. The search process is illustrated with a PRISMA diagram. Data were analysed using descriptive content analysis with the creation of thematic categories. Articles were evaluated according to the hierarchy of evidence, and their methodological quality was assessed using the MMAT and AMSTAR 2 tools. The final thematic analysis included 15 articles.
Results: Analysis of the included articles revealed two thematic categories: (1) the role of nurses in implementing telemedicine in mental health care, and (2) the perceived usefulness of telemedicine services for patients with mental health disorders. While the results show that the use of telehealth services has increased significantly, especially since the COVID-19 pandemic, they also highlight certain shortcomings.
Discussion and conclusion: Telemedicine has become an indispensable component of mental health care. Nurses play a central role in delivering safe, high-quality remote care. Ongoing implementation challenges highlight the need for further research to strengthen nursing competencies and enhance digital support in clinical practice.
Downloads
References
Aderemi, J. O., & Akinyemi, E. (2023). According to which criteria should telemental health be deemed elder inclusive? AMA Journal of Ethics, 25(10), E740–E744. https://doi.org/10.1001/amajethics.2023.740 PMid:37801057
American Telemedicine Association. (2006). Telemedicine, telehealth, and health information technology: An ATA issue paper. https://www.americantelemed.org
Ayuso Margañon, R., Llistosella, M., Ayuso Margañon, S., Rojano Navarro, M., Bou Gràcia, N., & Sillero Sillero, A. (2023). Nursing practice and telehealth in school health services: A scoping review. Healthcare, 11(24), Article 3124. https://doi.org/10.3390/healthcare11243124 PMid:38132014; PMCid:PMC10742839
Ažman, M. (2022). Human resource standards and norms as tools for ensuring quality and safety in nursing and midwifery. Obzornik zdravstvene nege, 56(1), 4–8. https://doi.org/10.14528/snr.2022.56.1.3166
Baird, M. B., Whitney, L., & Caedo, C. E. (2017). Experiences and attitudes among psychiatric mental health advanced practice nurses in the use of telemental health: Results of an online survey. Journal of the American Psychiatric Nurses Association, 24(3), 235–240. https://doi.org/10.1177/1078390317717330 PMid:28748728
Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024). Nurse-led interventions for improving medication adherence in chronic diseases: A systematic review. Healthcare, 12(23), Article 2337. https://doi.org/10.3390/healthcare12232337
Bernik, R., & Petek Šter, M. (2021). Varovanje osebnih podatkov v telemedicinskih storitvah. Zdravstveni Vestnik, 90(3/4), 159–172. https://doi.org/10.6016/ZdravVestn.3131
Bostrom, A. C. (2016). Technological advances in psychiatric nursing: An update. Nursing Clinics of North America, 51(2), 335–343. https://doi.org/10.1016/j.cnur.2016.01.012 PMid:27229283
Bright, A.-M., & Doody, O. (2023). Mental health service users’ experiences of telehealth interventions: An integrative review. Journal of Psychiatric and Mental Health Nursing, 30(1), 1–10. https://doi.org/10.1111/jpm.12893 PMid:36577690
Brunt, T. J., & Gale-Grant, O. (2023). Telepsychiatry: What clinicians need to know about digital mental healthcare. BJPsych Advances, 29(4), 230–238. https://doi.org/10.1192/bja.2022.42 PMid:37521104; PMCid:PMC10374879
Couch, J. V., Whitcomb, M., Buchheit, B. M., Dorr, D. A., Malinoski, D. J., Korthuis, P. T., Ono, S. S., & Levander, X. A. (2024). Patient perceptions of and experiences with stigma using telehealth for opioid use disorder treatment: A qualitative analysis. Harm Reduction Journal, 21(1), Article 125. https://doi.org/10.1186/s12954-024-01043-5 PMid:38937779; PMCid:PMC11210005
Deng, M., Zhai, S., Ouyang, X., Liu, Z., & Ross, B. (2022). Factors influencing medication adherence among patients with severe mental disorders from the perspective of mental health professionals. BMC Psychiatry, 22(1), Article 22. https://doi.org/10.1186/s12888-021-03681-6 PMid:34996394; PMCid:PMC8740063
Egede, C., Dawson, A. Z., Walker, R. J., Garacci, E., Campbell, J. A., & Egede, L. E. (2023). Relationship between mental health diagnoses and COVID-19 test positivity, hospitalization, and mortality in Southeast Wisconsin. Psychological Medicine, 53(3), 927–935. https://doi.org/10.1017/S0033291721002312 PMid:34034845; PMCid:PMC8185414
El Hayek, S., Nofal, M., Abdelrahman, D., Adra, A., Al Harthi, M., Al Shamli, S., Al Nuaimi, N., Bensid, L., Cheaito, M. A., Emberish, A. M., Larnaout, A., Radwan, A., Slaih, M., Kobeissy, F., & Bizri, M. (2020). Telepsychiatry in the Arab world: A viewpoint before and during COVID-19. Neuropsychiatric Disease and Treatment, 16, 2805–2815. https://doi.org/10.2147/NDT.S277224 PMid:33239877; PMCid:PMC7682595
Elendu, C. (2024). The evolution of ancient healing practices: From shamanism to Hippocratic medicine: A review. Medicine, 103(28), Article e39005. https://doi.org/10.1097/MD.0000000000039005 PMid:38996102; PMCid:PMC11245246
Ellington, E. (2013). Telepsychiatry by APRNs: An answer to the shortage of pediatric providers? Issues in Mental Health Nursing, 34(9), 719–721. https://doi.org/10.3109/01612840.2013.784386 PMid:24004367
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x PMid:18352969
Fikrie, A., Daniel, D., Ermiyas, S., Hassen, H., Seyoum, W., Kebede, S., & Wako, W. G. (2025). Magnitude of telemedicine utilization and associated factors among health professionals working at selected public hospitals in Southern Ethiopia. PLOS ONE, 20(1), Article e0311956. https://doi.org/10.1371/journal.pone.0311956 PMid:39752509; PMCid:PMC11698327
Finley, B. A. (2019). Psychiatric mental health nurse practitioners meeting rural mental health challenges. Journal of the American Psychiatric Nurses Association, 26(1), 97–101. https://doi.org/10.1177/1078390319886357 PMid:31729273
Finley, B. A., Shea, K. D., Maixner, R., & Slebodnik, M. (2020). Advanced practice registered nurses using synchronous telepsychiatry: An integrative systematic review. Journal of the American Psychiatric Nurses Association, 27(4), 271–283. https://doi.org/10.1177/1078390320939159 PMid:32648509
GBD 2019 Mental Disorders Collaborators. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3 PMid:35026139
Gilson, T., Stewart, C., & Hodgson, D. (2025). Telehealth in mental health social work: Benefits and limitations within practice. Australian Social Work, 78(3), 261–273. https://doi.org/10.1080/0312407X.2024.2380350
Goldstein, F., & Glueck, D. (2016). Developing rapport and therapeutic alliance during telemental health sessions with children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(3), 204–211. https://doi.org/10.1089/cap.2015.0022 PMid:26491890
Greenwood, H., Krzyzaniak, N., Peiris, R., Clark, J., Scott, A. M., Cardona, M., Griffith, R., & Glasziou, P. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of randomized controlled trials. JMIR Mental Health, 9(3), Article e31780. https://doi.org/10.2196/31780 PMid:35275081; PMCid:PMC8956990
Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., & Hudson, M. (2002). What does "access to health care" mean? Journal of Health Services Research & Policy, 7(3), 186–188. https://doi.org/10.1258/135581902760082517 PMid:12171751
Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, Article 100117. https://doi.org/10.1016/j.sintl.2021.100117 PMid:34806053; PMCid:PMC8590973
Hoffmann, M., Wensing, M., Peters-Klimm, F., Szecsenyi, J., Hartmann, M., Friederich, H. C., & Haun, M. W. (2020). Perspectives of psychotherapists and psychiatrists on mental health care integration within primary care via video consultations: Qualitative preimplementation study. Journal of Medical Internet Research, 22(6), Article e17569. https://doi.org/10.2196/17569 PMid:32554369; PMCid:PMC7333073
Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., Vedel, I., & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information, 34(4), 401–411. https://doi.org/10.3233/EFI-180221
Jørgensen, S. W., Lee, K., Klausen, S. H., Petersen, E. N., & Nørgaard, B. (2023). Patients’ perspectives on telemedicine in the encounter between healthcare and patients with mental illness: A systematic review. European Journal of Psychiatry, 37(1), 44–62. https://doi.org/10.1016/j.ejpsy.2022.08.003
Jeon, H.-L., Kwon, J. S., Park, S.-H., & Shin, J.-Y. (2021). Association of mental disorders with SARS-CoV-2 infection and severe health outcomes: Nationwide cohort study. The British Journal of Psychiatry, 218(6), 344–351. https://doi.org/10.1192/bjp.2020.251 PMid:33407954
Kendler, K. S., Tabb, K., & Wright, J. (2022). The emergence of psychiatry: 1650–1850. American Journal of Psychiatry, 179(5), 329–335. https://doi.org/10.1176/appi.ajp.21060614 PMid:35331024
Koblauch, H., Reinhardt, S. M., Lissau, W., & Jensen, P.-L. (2016). The effect of telepsychiatric modalities on reduction of readmissions in psychiatric settings: A systematic review. Journal of Telemedicine and Telecare, 24(1), 31–36. https://doi.org/10.1177/1357633X16670285 PMid:27663681; PMCid:PMC5768249
Kodermac, N., & Peršolja, M. (2024). Zadovoljstvo pacientov z informacijskim sistemom eZdravje v splošni bolnišnici: presečna raziskava. Obzornik zdravstvene nege, 58(4), 271–278. https://doi.org/10.14528/snr.2024.58.4.3266
Kramar, Z., & Bregar, B. (Eds.). (2021). Kadrovski standardi in normativi v zdravstveni in babiški negi. Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije. https://www.zbornica-zveza.si/wp-content/uploads/2021/07/Z_Z_Kadrovski-standardi_2021_splet.pdf
Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., García-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2018). High-quality health systems in the sustainable development goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3 PMid:30196093
Kushwah, A. (2024). Opportunities and challenges in digital health and telepsychiatry: A narrative review. Balkan Journal of Interdisciplinary Research, 10(1), 39–48.
Lawes-Wickwar, S., McBain, H., & Mulligan, K. (2018). Application and effectiveness of telehealth to support severe mental illness management: Systematic review. JMIR Mental Health, 5(4), Article e8816. https://doi.org/10.2196/mental.8816 PMid:30463836; PMCid:PMC6314801
Liew, A., Monkman, H., Palmer, R., Kollaja, L., Rodriguez, K., Ijams, S., Homco, J., Laurent, J., Wickham, A., Wen, F., & Lesselroth, B. (2023). A telepsychiatry simulation for suicide assessment: Teaching telemedicine safety competencies. AMIA Annual Symposium Proceedings, 2022, 700–708.
Lin, B., Costakis, A., John, M., & Linder, H. (2023). Decreased inpatient psychiatric admissions with telepsychiatry use during the COVID-19 pandemic. Frontiers in Psychiatry, 14, Article 1172019. https://doi.org/10.3389/fpsyt.2023.1172019 PMid:37351003; PMCid:PMC10284274
Link, K., Christians, S., Hoffmann, W., & Röhr, S. (2023). Telemedical treatment of patients with mental disorders during and after the first COVID-19 pandemic lockdown in Germany: An observational study on feasibility and patient satisfaction. BMC Psychiatry, 23, Article 654. https://doi.org/10.1186/s12888-023-05140-w PMid:37670236; PMCid:PMC10478407
Ma, Q., Sun, D., Tan, Z., Li, C., He, X., Zhai, Y., Wang, L., Cui, F., Li, M., Gao, J., Wang, L., & Zhao, J. (2022). Usage and perceptions of telemedicine among health care professionals in China. International Journal of Medical Informatics, 166, Article 104856. https://doi.org/10.1016/j.ijmedinf.2022.104856 PMid:36037593
Maier, C. B. (2019). Nurse prescribing of medicines in 13 European countries. Human Resources for Health, 17, Article 95. https://doi.org/10.1186/s12960-019-0429-6
McVay, M. R. (2022). Medicine and spirituality: A simple path to restore compassion in medicine. South Dakota Medicine, 75(11), 487–491.
Núñez, A., Sreeganga, S. D., & Ramaprasad, A. (2021). Access to healthcare during COVID-19. International Journal of Environmental Research and Public Health, 18(6), Article 2980. https://doi.org/10.3390/ijerph18062980 PMid:33799417; PMCid:PMC7999346
O’Reilly, M., & Lester, J. N. (2017). History of mental health and mental illness. In Examining mental health through social constructionism: The language of mental health (pp. 31–51). Palgrave Macmillan. https://doi.org/10.1007/978-3-319-60095-6_2
Omboni, S., Padwal, R. S., Alessa, T., Benczúr, B., Green, B. B., Hubbard, I., Kario, K., Khan, N. A., Konradi, A., Logan, A. G., Lu, Y., Mars, M., McManus, R. J., Melville, S., Neumann, C. L., Parati, G., Renna, N. F., Ryvlin, P., Saner, H., … Wang, J. (2022). The worldwide impact of telemedicine during COVID-19: Current evidence and recommendations for the future. Connected Health, 1, 7–35. https://doi.org/10.20517/ch.2021.03 PMid:35233563; PMCid:PMC7612439
Ostrowski, J., & Collins, T. P. (2016). A comparison of telemental health terminology used across mental health state licensure boards. The Professional Counselor, 6(4), 387–396.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Polit, D. F., & Beck, C. T. (2021). Essentials of nursing research (10th ed.). Wolters Kluwer.
Pujolar, G., Oliver-Anglès, A., Vargas, I., & Vázquez, M. L. (2022). Changes in access to health services during the COVID-19 pandemic: A scoping review. International Journal of Environmental Research and Public Health, 19(3), Article 1749. https://doi.org/10.3390/ijerph19031749 PMid:35162772; PMCid:PMC8834942
Sánchez-Guarnido, A. J., Gonzalez-Vilchez, M., de Haro, R., Fernández-Guillen, M., Graell-Gabriel, M., & Lucena-Jurado, V. (2022). Nursing and telemental health during the COVID-19 pandemic. Healthcare, 10(2), Article 273. https://doi.org/10.3390/healthcare10020273 PMid:35206886; PMCid:PMC8871975
Schulze, L. N., Stentzel, U., Leipert, J., Schulte, J., Langosch, J., Freyberger, H. J., & van den Berg, N. (2019). Improving medication adherence with telemedicine for adults with severe mental illness. Psychiatric Services, 70(3), 225–228. https://doi.org/10.1176/appi.ps.201800286 PMid:30651059
Schroeder, R. A. (2022). Adaptation or revolution: Telemental health and advanced practice psychiatric nursing during COVID-19. Journal of the American Psychiatric Nurses Association, 28(3), 241–248. https://doi.org/10.1177/1078390320970638 PMid:33164642
Segre, L. S., McCabe, J. E., Chuffo Davila, A., & Arndt, S. (2022). Telehealth Listening Visits for emotionally distressed mothers of hospitalized newborns: Proof-of-concept. Frontiers in Psychiatry, 13, Article 1032419. https://doi.org/10.3389/fpsyt.2022.1032419 PMid:36569622; PMCid:PMC9768023
Shalev, D., Brenner, K., Carlson, R. L., Bernard, J. D., & Nakonezny, P. A. (2024). Palliative care psychiatry: Building synergy across the spectrum. Current Psychiatry Reports, 26(3), 60–72. https://doi.org/10.1007/s11920-024-01485-5
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, Article j4008. https://doi.org/10.1136/bmj.j4008 PMid:28935701; PMCid:PMC5833365
Sheriff, R., Hong, J. S. W., Henshall, C., D'Agostino, A., Tomassi, S., Stein, H. C., Cerveri, G., Cibra, C., Bonora, S., Giordano, B., Smith, T., Phiri, P., Asher, C., Elliot, K., Zangani, C., Ede, R., Saad, F., Smith, K. A., & Cipriani, A. (2023). Evaluation of telepsychiatry during the COVID-19 pandemic across service users, carers and clinicians: An international mixed-methods study. BMJ Mental Health, 26(1), Article e300646. https://doi.org/10.1136/bmjment-2022-300646 PMid:37567731; PMCid:PMC10577786
Shore, J. H., Schneck, C. D., & Mishkind, M. C. (2020). Telepsychiatry and the coronavirus disease 2019 pandemic: Current and future outcomes of the rapid virtualization of psychiatric care. JAMA Psychiatry, 77(12), 1211–1212. https://doi.org/10.1001/jamapsychiatry.2020.1643 PMid:32391861
Shorter, E. (2015). What psychiatry left out of the DSM-5: Historical mental disorders today. Routledge. https://doi.org/10.4324/9781315736990
Smolić, Š., Čipin, I., & Međimurec, P. (2022). Access to healthcare for people aged 50+ in Europe during the COVID-19 outbreak. European Journal of Ageing, 19(4), 793–809. https://doi.org/10.1007/s10433-021-00631-9 PMid:34149338; PMCid:PMC8195455
Stein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., Sartorius, N., & Maj, M. (2022). Psychiatric diagnosis and treatment in the 21st century: Paradigm shifts versus incremental integration. World Psychiatry, 21(3), 393–414. https://doi.org/10.1002/wps.20998 PMid:36073709; PMCid:PMC9453916
Surís, A., Holliday, R., & North, C. S. (2016). The evolution of the classification of psychiatric disorders. Behavioral Sciences, 6(1), Article 5. https://doi.org/10.3390/bs6010005 PMid:26797641; PMCid:PMC4810039
Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247–1257. https://doi.org/10.1002/nop2.1434 PMid:36303066; PMCid:PMC9912424
Tzur Bitan, D., Krieger, I., Kridin, K., Komantscher, D., Scheinman, Y., Weinstein, O., Cohen, A. D., Cicurel, A. A., & Feingold, D. (2021). COVID-19 prevalence and mortality among schizophrenia patients: A large-scale retrospective cohort study. Schizophrenia Bulletin, 47(5), 1211–1217. https://doi.org/10.1093/schbul/sbab012 PMid:33604657; PMCid:PMC7928567
Uscher-Pines, L., Parks, A. M., Sousa, J., Raja, P., Mehrotra, A., Huskamp, H. A., & Busch, A. B. (2022). Appropriateness of telemedicine versus in-person care: A qualitative exploration of psychiatrists' decision making. Psychiatric Services, 73(8), 849–855. https://doi.org/10.1176/appi.ps.202100519 PMid:35080419; PMCid:PMC9348900
Vaismoradi, M., Rae, J., Turunen, H., & Logan, P. A. (2024). Specialized nurses’ role in ensuring patient safety within the context of telehealth in home care: A scoping review. Digital Health, 10, Article 20552076241287272. https://doi.org/10.1177/20552076241287272 PMid:39381815; PMCid:PMC11459674
Wittson, C. L., & Dutton, R. A. (1956). New tool for psychiatric education. Psychiatric Services, 7(9), 11–14. https://doi.org/10.1176/ps.7.9.11
World Health Organization. (2022, March 2). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide
World Health Organization. (2024, July 15). WHO develops guidance to improve telemedicine services. https://www.who.int/europe/news-room/15-07-2024-who-develops-guidance-to-improve-telemedicine-services
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Slovenian Nursing Review

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.













