When Telehealth Fits and Fails in Youth Mental Health Care
Tracks
Room 3
| Wednesday, December 2, 2026 |
| 11:10 AM - 11:30 AM |
| Concurrent Room 2 |
Overview
Dr Emilie Francis-Auton
Speaker
Dr Emilie Francis-Auton
Australian Institute of Health Innovation, Macquarie University
When Telehealth Fits and Fails in Youth Mental Health Care
Abstract
Aim: Telehealth is often positioned as a scalable approach to enhancing access to child and adolescent mental health services, yet limited attention has been paid to the human factors shaping it delivery. The effectiveness of telehealth is not inherent but depends on how well systems fit the cognitive, sensory and contextual needs of children and adolescents. This systematic review adopts a human factors perspective to identify conditions under which telehealth achieves a “perfect fit”, and where misalignments compromise quality and safety.
Method: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and followed a published protocol. Four databases (EMBASE, MEDLINE, PsycINFO and CINAHL) were searched for studies published between January 2020 and April 2025. Included studies involved psychologist-delivered interventions via telehealth for individuals under 18 years with a diagnosed mental health condition. Findings were synthesised to identify barriers and enablers across individual, organisational, and system levels.
Results: Twenty-three studies were included (quasi-experimental, n=17; randomised control trials, n=2; mixed methods, n=2; qualitative, n=2). Ten studies used video-only modalities, nine combined video and telephone, and four employed hybrid models of care. Clinical areas included neurodevelopmental conditions, behavioural issues, anxiety and trauma. Models of care encompassed individual and caregiver therapy, group interventions, assessment, management, and outpatient programs. Key individual-level barriers included sensory distraction and developmental suitability, while organisational enablers included adaptable protocols and clinician training.
Implications: These findings reframe telehealth as a dynamic system requiring continuous alignment between people, technologies and contexts. Rather than a universal solution, its safety and effectiveness depends on identifying and correcting mismatches in real-world use. Human factors principles addressing usability, cognitive demands and system adaptability, provide a critical pathway to designing telehealth models that achieve a better, more equitable fit in an evolving health landscape.
Method: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and followed a published protocol. Four databases (EMBASE, MEDLINE, PsycINFO and CINAHL) were searched for studies published between January 2020 and April 2025. Included studies involved psychologist-delivered interventions via telehealth for individuals under 18 years with a diagnosed mental health condition. Findings were synthesised to identify barriers and enablers across individual, organisational, and system levels.
Results: Twenty-three studies were included (quasi-experimental, n=17; randomised control trials, n=2; mixed methods, n=2; qualitative, n=2). Ten studies used video-only modalities, nine combined video and telephone, and four employed hybrid models of care. Clinical areas included neurodevelopmental conditions, behavioural issues, anxiety and trauma. Models of care encompassed individual and caregiver therapy, group interventions, assessment, management, and outpatient programs. Key individual-level barriers included sensory distraction and developmental suitability, while organisational enablers included adaptable protocols and clinician training.
Implications: These findings reframe telehealth as a dynamic system requiring continuous alignment between people, technologies and contexts. Rather than a universal solution, its safety and effectiveness depends on identifying and correcting mismatches in real-world use. Human factors principles addressing usability, cognitive demands and system adaptability, provide a critical pathway to designing telehealth models that achieve a better, more equitable fit in an evolving health landscape.
Biography
Emilie Francis-Auton is a Research Fellow at the Australian Institute of Health Innovation at Macquarie University. With a background in sociology and qualitative health research, her work focuses on improving healthcare systems through co-design, implementation science, and human-centred approaches to service improvement.
Emilie’s research explores patient and clinician experiences within complex healthcare environments, particularly emergency care and disability-inclusive healthcare. She has expertise in qualitative and mixed-methods research, including interviews, participatory co-design, and realist evaluation, with a strong focus on translating research findings into practical improvements for healthcare delivery, communication, and organisational change.
