Telepsychiatry is the clinical practice of psychiatry through the use of telecommunication technology. With this type of virtual care, mental health professionals can connect with patients through HIPAA secure video calls and text messaging who live in isolated or rural areas and those that have other barriers to accessing healthcare. Tele psychiatrists are licensed mental health professionals who practice telemedicine using audio or video conferencing applications, such as Hucu.ai HIPAA compliant app for video conferencing, two-way text messaging and sharing health records on cloud-based data storage. In some cases, they may even meet with patients in person at their remote locations. To become a tele psychiatrist, you’ll need to complete at least a bachelor’s degree in psychology, social work, speech pathology, or another related field and an internship focusing on telemedicine.
Jim Varrell, M.D., an American Board Certified Psychiatrist and Neurologist specializing in autism, is a member of the American Academy of Child and Adolescent Psychiatry. He has been at the forefront of telepsychiatry across the country, educating the medical community about its advantages through various lectures and events. He currently performs telepsychiatry evaluations and supervises a group of telepsychiatrists who serve patients in 26 states.
Jim Varrell said I have worked as an in-person child and adolescent psychiatrist for many years before shifting to telepsychiatry. I have learned about the subtle differences and nuances between the two forms of care.
A Day in the Life of a Telepsychiatrist
Many telepsychiatrists work for large medical companies that employ various mental health professionals, including psychologists and social workers. In these positions, telepsychiatrists provide both in-person and virtual healthcare solutions, such as Hucu.ai. Depending on the company, you may be expected to work a set number of hours per week or be on call 24/7. You can expect to work more varied hours in private practice, including evenings and weekends. You’ll likely have more one-on-one time with patients and be expected to maintain regular office hours, such as 9-5 during the week. In private practice, you’ll likely be expected to treat a variety of patients with various mental health issues. For example, you may treat children with anxiety, adolescents with depression, and adults with schizophrenia.
Building Trust with Children
While building trust with all patients is important, it’s especially crucial when caring for children who may have never seen a mental health professional before. Since children live exploring and discovering the world, they may have fears and concerns that could impact their mental health. For example, children may struggle with feelings of isolation due to bullying, shame surrounding a traumatic event such as sexual abuse, or anxiety around a health condition like epilepsy. For children, the process of building trust begins with education. You can introduce yourself, explain how you work, and let the child’s parents know who you are and how you can assist their child. Once the child feels comfortable communicating with you, you can begin to explore what they are experiencing. You may explore things like their interests, fears, and worries and what they hope to gain from therapy.
Telepsychiatry working with children and adolescents can be particularly effective. A 15-year-old patient was admitted to the hospital for the fourth time with severe abdominal pain that was not medically caused. The hospital staff was perplexed, as diagnostic tests did not indicate any health problems, and the child had no physical problems. Another psychiatrist at the hospital had already evaluated the youth and been unable to ‘open him up,’ yet he was diagnosed with the same condition as the present patient.
A caring on-site staff member noticed that the teen was interested in technology and suggested that a telemedicine cart, which was usually used in the ED, be brought to his room so that he could speak to a telepsychiatrist specializing in child and adolescent psychiatry via video conferencing. Although the teen preferred to talk to me onscreen rather than in person, his peers were able to establish a connection with him. During our session, I could use his interest in technology and my experience in child and adolescent psychiatry to help him feel more comfortable sharing his story. In the past, his brother had been shot in the stomach, causing psychological trauma that led to abdominal pain.
The costly and time-consuming medical intervention was replaced with appropriate psychiatric treatment after our conversation in the case of the boy with stomach pain.
Research has shown that technology can positively affect children in a clinical setting, just as my experiences have. In one study, adolescents reported that telemedicine made them feel more comfortable terminating a medical consultation or leaving, that it was more structured, and that they received better information, which helped them understand, feel a sense of shared responsibility, and make better decisions.
Helping Patients Manage Depression and Anxiety
Depending on the patient, you may be required to use different intervention techniques when helping them manage depression and anxiety. For example, patients who are experiencing major depressive disorder may be prescribed antidepressant medications. Telepsychiatrists often help patients manage the dosage and timing of these medications. You can help patients manage anxiety by exploring what triggers it and how it impacts their daily lives. It can help patients identify what steps they can take to reduce anxiety. For example, when anxiety is triggered, patients may benefit from regular exercise, therapy sessions, or speaking with a trusted loved one.
Working With Adults Who Struggle with Co-occurring Mental Health Conditions and Substance Abuse
When working with adults who struggle with co-occurring mental health conditions and substance abuse, you’ll likely be focused on helping them manage their substance abuse. If the patient is currently abusing substances, you may work with them to develop a treatment plan that includes entering treatment for substance abuse. You can also help patients explore substance abuse’s impact on their lives, which may cause them to experience co-occurring mental health conditions. For example, if a patient is experiencing anxiety and depression, you can help them explore what factors contribute to anxiety and depression. You may discover that substance abuse is impacting those symptoms. You can help patients manage anxiety and depression by analyzing what triggers symptoms and what they can do to reduce their experiences.
Patients with autism and other special needs may benefit from provider adaptations while using telepsychiatry, which can be similar to in-person psychiatry. Providers can enhance a patient’s response by being flexible. Slowing down your speech, using gestures, and remembering not to speak to children as if they were infants are ways to improve your patient-provider relationship. Telepsychiatrists can employ games and inquiries to engage children more casually. While using telepsychiatry, I have gained a child’s trust and elicited meaningful responses by including parents and on-site facilitators in the session.
Telepsychiatry is one way to expand access to mental health services in rural and underserved areas. While it has limitations, research shows that virtual care can be effective. When delivering mental health care via virtual methods like secure video conferencing, it is crucial to be aware of particular challenges, such as the impact of the quality of the connection on the therapeutic relationship and the importance of building trust even when that’s difficult. Telepsychiatry allows for more flexibility in scheduling sessions, which can benefit patients who need more time to travel to their appointments. It also provides more privacy, especially for children, who often are reluctant to talk if others can overhear them. If you’re interested in exploring careers in telemedicine, there are many types of virtual careers. Suppose you’re interested in being a tele psychiatrist. In that case, you’ll need to complete at least a bachelor’s degree in psychology, social work, speech pathology, or another related field and an internship focusing on telemedicine.
Specialty care can be provided in a way that caters to the preferences and needs of each individual, especially children. Telemedicine is an excellent tool for delivering more specialty care options and ensuring that every patient receives the right physician and treatment.