(PS8-D83) Provider Perspectives on Delivering Tele-mental Health Services for Latinx Populations

Provision of behavioral health care in the United States has long been subject to a range of systemic and structural factors impacting availability, access, and acceptability. Barriers to treatment are especially prevalent in rural settings and among marginalized and under-resourced populations, though the need for services is equally pronounced. Latinx populations, in particular, are disparately affected by factors influencing their ability to travel to and pay for health services, such as greater poverty, higher rates of unemployment, and lower rates of insurance coverage. These barriers were exacerbated by the COVID-19 pandemic, prompting the need for innovative methods in service delivery. Telehealth is one way to facilitate access and continuity of care to all individuals, during the pandemic and beyond. To inform ongoing and future implementation of telehealth, particularly among Latinx populations, we gathered provider perspectives from El Futuro, a North Carolina nonprofit organization that provides and advances behavioral health treatment for urban and rural, Spanish-speaking individuals and families. Providers completed telehealth services with patients presenting primarily with PTSD, anxiety and/or depression (N=899). As part of a larger telehealth outcome study, semi-structured interviews were subsequently conducted with El Futuro service providers (N=7) to collect information on their experiences implementing a tele-mental health program for rural, Latinx clients in North Carolina. Select program staff also completed a repeated qualitative survey on implementation ‘peaks and valleys’ to describe challenges encountered, and strategies enacted, in relation to the following categories: recruitment and accessibility, privacy, data systems and internal infrastructure, therapeutic process, and finances. The study team used a rapid qualitative analysis approach to identify and organize themes across all provider interviews and qualitative surveys. Key themes around telehealth implementation were identified across three main categories: 1) establishing technology-based infrastructure, 2) maintaining provider engagement, and 3) maintaining client engagement. Providers reported that telehealth circumvented many of the regular barriers to care that they’ve previously observed among their client population, including transportation issues, work and school conflicts, lack of childcare, and even confidentiality concerns. Provider perspectives can inform and refine implementation of telehealth services to promote availability, access, and acceptability of behavioral health services for all, including underserved communities.