How Mental Healthcare Professionals Navigate Telehealth: Extensions of Communication Privacy Management and Electronic Propinquity Theories

Abstract

Remote mental healthcare has become a new normal, yet there is limited research on how mental healthcare professionals create safe, secure virtual environments for patients while in separate physical locations. Computer-mediated communication theories are well-suited for exploring, and even improving, this critical endeavor. We do this by elaborating communication privacy management (CPM) theory to recognize the boundary coordination involved in contemporary videoconferencing, as exemplified in telehealth interactions. Furthermore, we expand the theory of electronic propinquity (TEP) to appreciate the role of medium-related digital skills in shaping online propinquity. Interviews with 20 mental healthcare professionals reveal that boundary coordination in telemental healthcare takes place in both the shared virtual space and separate physical spaces. Moreover, boundaries are more fluid, or elastic, than CPM allows. We also find that participants generally felt very close to their clients over telehealth, although the digital skills of clients sometimes disrupted care. In addition to these theoretical findings, this research yields practical insights into privacy boundary coordination strategies for telehealth for mental healthcare providers.