Video Interviewing for a Large, National, Mental Health Study

Leveraging video-based interviewing in households, prisons, homeless shelters, and hospitals due to COVID-19 restrictions

Video interviews in the wake of a global pandemic – a new paradigm

The widespread isolation and lockdown measures that quickly went into place during the first year of COVID-19 had a significant impact on in-person data collection, forcing survey research studies to either pause or change the mode of data collection. In addition to web, phone and mail modes, video-based interviewing quickly became a viable option given that approximately 85% of adults own a smartphone, an increase of more than double in the last 10 years, approximately 75% own a laptop or PC and 53% own a tablet computer. Additionally, non-household settings, such as prisons, psychiatric hospitals, and homeless shelters, did not permit in-person data collection at times during COVID-19, but embraced video interviewing. The availability and features of video-based platforms such as Zoom, WebEx, Microsoft Teams, and Blue Jeans led to the development of video-based interviewing protocols and systems.

The National Study of Mental Health (NSMH)

The National Study of Mental Health (NSMH) began data collection in October 2020, in the midst of the COVID-19 pandemic. The primary aim of the study was to estimate the prevalence rates of serious mental health and substance use disorders among U.S. adults ages 18-65, by interviewing participants who reside in households, prisons, homeless shelters, and state psychiatric hospitals.

The original study design estimated that 80% of household interviews would be conducted by video and the facility-based interviews would be conducted in person. Video interviewing was planned for the national household sample as a cost-saving measure as well as the need for the clinical interviewer to observe the demeanor and behavior of sample members given the disorders of interest, which included schizophrenia and bipolar disorder. However, up to that point, video-based interviewing had not been allowed in facility settings. The national shift to telehealth and legal visits by video due to the pandemic led to the acceptance of video-based interviewing as an option for respondents within facility settings.

Benefits of video interviews

Video interviewing offers many of the same advantages as in-person interviews while increasing efficiency. These benefits include reduced travel costs, increased direct eye contact, improved rapport, and the ability to share the screen (i.e., show cards, consent forms). Additionally, the interviewer can evaluate environmental cues and respondent engagement and reactions, which may lead to strategies that also improve completion rates and data quality.

For vulnerable populations, such as those with mental health concerns or in non-household settings, video interviewing may provide a safe environment for both respondent and interviewer and feel less intrusive than an in-person interview. Most video platforms also offer the benefit of supporting both video- and phone-based interviewing modes and recording video and audio files, which are stored in a secure cloud location. Furthermore, video recordings provide an easy way to confirm authentication of the interviews, conduct quality control reviews, and allow other expert clinicians to re-evaluate the scoring of mental health issues as necessary.

Scheduling support for video interviews is critical

NSMH-eligible respondents were invited to participate in an 80-minute clinical interview via Zoom with a professional clinical interviewer. Our team implemented a web scheduler to enable selected participants to select a date for their interview, based on the availability of interviewers. Once the participant selected a date and time, the automated scheduler reserved the interviewer’s time, assigned the case to the interviewer, and sent automated emails to the participant, interviewer, and data collection manager, notifying them of the scheduled appointment. Interviewing protocols were developed that included creating a Zoom meeting invitation with a video link and attachments that were sent to respondents and resulted in a calendar invitation placed in both the participant’s and the interviewer’s schedules. 

Interviewers were also provided with a follow-up contacting strategy. The web scheduler sent participants automated appointment reminders (1 day, 7 days, and 21 days before the appointment) as well as automated reminders to interviewers to send Zoom information to participants and to upload interview recordings after the scheduled interview. After the interview was completed, NSMH interviewers moved the recorded interviews from the secure cloud location to a private project website that allowed on-going quality control review in an easy-to-access location while simultaneously securing the files behind 2-factor firewalls.

Positive participant feedback from NSMH video interviews

Close to 3,500 video interviews and 1,600 phone interviews were conducted on the NSMH project via Zoom in the household, prison, homeless shelter, and hospital settings. All interviews with household respondents were conducted via Zoom, whereas facility respondents completed video-based interviews at times when in-person data collection was not possible due to COVID-19 safety precautions. Interviewers used two devices when conducting the video interviews—a laptop to administer the interview and record the responses and a tablet for the Zoom video connection. Interview lengths and data quality were similar for video, phone, and in-person interviews.

NSMH respondents have provided positive feedback on the video-based interviewing experience. Of the respondents completing video interviews, 94.5% stated that they were “comfortable” or “very comfortable” with the video interview format and only 8.6% experienced some form of technical difficulties, which were resolved and did not impede the completion of the interview. Additionally, interviewers found it very helpful to be able to see the respondent’s behavior and/or facial expressions when coding mental health symptoms and substance use reported by the respondent during the interview.

Future of video-based data collection

The COVID-19 pandemic led to video-based interviewing for household and non-household participants, thereby developing a new capability for RTI data collection, as well as production testing a new interview mode and new technical systems on a large, complex, national study conducted in multiple settings. This cost-efficient novel approach continues to be a viable option 2.5 years after the initial onset of the COVID-19 pandemic as in-person data collection is becoming increasingly difficult due to labor shortages and response rates continue to suffer. Video-based interviewing offers a secure option that optimizes the benefits of in-person data collection while reducing other inherent risks and costs.