The importance of external clinical facilitation for a perinatal and infant telemental health service.

Clinical facilitation is an established strategy for introducing innovation into clinical practice. The Queensland Centre for Perinatal and Infant Mental Health has used clinical facilitation to establish a telehealth service to support perinatal and infant mental health in regional, rural and remote areas of the Australian state of Queensland. The aim of this study is to explore the role of clinical facilitation in implementing and sustaining the telehealth service. Semi-structured interviews were conducted with 14 remote-site users of the telehealth service. Interviews were analysed using thematic analysis. Two dominant themes emerged: unmet need and service visibility. The study confirms the usefulness of telehealth as a way to address unmet need for specialist mental health services in regional, rural and remote areas. The study also provides evidence that a telehealth service with intermittent demand requires a consistent clinical facilitator, to keep the service visible to remote-site clinicians and maintain awareness of the service as a referral option. Previous research has identified the importance of clinical facilitation in initial service implementation. This study demonstrates the necessity of clinical facilitation for ongoing service provision. Facilitation is likely to be more important where the telehealth service responds to intermittent or infrequent clinical need, compared with high-volume services where clinics are conducted routinely.