Tag Archives: behavioral health

Building a Better Behavioral Health Benefit with Telepsychiatry

By: Barry Doan

Original article published on Benefits Pro

The value of an employer’s health benefit strategy is intrinsically linked to its ability to address an employee’s total health—both physical and mental. That’s why overall wellness trends are shifting to better acknowledge the strong connection between a robust behavioral health care benefit and better overall health, ultimately resulting in improved employee productivity.

While many wellness programs today incorporate tactics that promote positive behavioral lifestyle changes, they often fall short of systematically addressing behavioral health conditions that can hinder an employee’s willingness and ability to embrace those needed changes. Altering entrenched behavioral health lifestyle patterns can be difficult, even if it’s a change that would be beneficial for the member. For instance, diabetic employees are much less likely to engage in diet and exercise programs when they are struggling with active depression that robs them of energy, focus and motivation. These members often represent a substantial percentage of those with chronic health conditions who make up a disproportional share of total healthcare expenditures.

This reality is why many companies are setting their sights on comprehensive employee “well-being” as opposed to “wellness” alone. By prioritizing access to both physical and behavioral health care, employers set the stage for more systemic and long-lasting engagement in self-care—and ultimately improve employee well-being, productivity and the bottom line. It’s important to note, however, that while many companies have invested heavily in identifying high-risk, high-cost employees and programs to engage these employees, access to care is still a major obstacle to this change process.

As part of this shift, many employers are incorporating telemedicine options into health benefit packages as a viable solution for addressing access issues related to traditional in-office care. Telepsychiatry is emerging as a growing opportunity within this movement as an effective means of overcoming common barriers to behavioral health utilization such as stigma, busy lifestyles and poor coordination of services. These models help attract busy and reluctant employees who might otherwise procrastinate getting the help they need.

As a clinical model that leverages videoconferencing technology, telepsychiatry and telebehavioral health are used for evaluations, consultations and ongoing treatment. Employees access this care through live, interactive communication with a licensed psychiatry or behavioral health provider in a private setting. This improved access allows employees to not only address their behavioral health concerns before issues become more acute and costly, but also to reduce the behavioral health impairment that interferes with their ability and desire to engage in employer wellness programs.

The behavioral health challenge

The statistics speak for themselves. Behavioral health issues were the leading cause of disability in 2015, accounting for one-third of new claims.

Depression, for instance, ranks high as an employer health challenge, racking up an estimated $210.5 billion per year — nearly half of which is attributed to workplace absenteeism and productivity losses. In fact, one study points to employer costs as high as $3,386 per individual over a two-year period prior to an employee’s depression diagnosis.

Behavioral health issues often impact the effectiveness of wellness programs directed at physical conditions due to existing co-morbidities. One study found that 45 percent of breast cancer patients also had a psychiatric disorder.

While these statistics may be startling, the good news is that companies can achieve notable return on investment in wellness and complex condition management programs by investing in mental health treatment. In one study, researchers found that for every dollar spent treating depression, $1.55 was spent on the effects of depression in the workplace.

It’s not always easy to quantify the impact of behavioral health treatment, but human resource managers overwhelmingly agree that a healthy, well balanced employee is a better teammate and more productive worker. Often, the problem is getting employees to utilize the behavioral health benefits that are already available to them.

Consider a common example: A company launches an active lifestyle program that includes tracking daily physical activity as one means of supporting the employee’s goals of improving her health. A single mom in the workforce, who already struggles with mild depression and anxiety, finds it difficult to rise to the challenge of addressing her wellness goals. Feelings of guilt and inadequacy over this “failure” exacerbate her behavioral health conditions, ultimately decreasing her physical activity and lowering her overall health scores. Unfortunately, the wellness coach does not recognize the behavioral health condition that is impairing participation and fails to make an appropriate referral for additional professional support. The employee becomes demoralized, feels even worse and drops out of the program, and an opportunity is lost.

Even when the employee recognizes the underlying behavioral health condition that is compromising her health and happiness, she may have challenges taking the desired action to address it. While an existing behavioral health benefit would cover the employee’s treatment, she still must do the following research:

  • Identify what is wrong and what type of provider she needs to find
  • Determine what her benefits cover
  • Find which providers can she see that are covered
  • Schedule her appointment
  • Manage the logistics of attending the appointment which may include taking time off and arranging child care and transportation

Taking hold of the telepsychiatry opportunity

Offering telepsychiatry and other behavioral health care services as part of employee benefits is a trend on the rise, and for good reason

When employees can access psychiatrists and therapists from the comfort of their home or another private space, the behavioral health stigmas are reduced, and individuals are more apt to follow through with care plans. Privacy and confidentiality are also stronger with telepsychiatry because online sessions eliminate the potential of individuals seeing someone they know in a waiting room. Many patients also report greater comfort addressing difficult issues while in familiar surroundings.

Additionally, telepsychiatry expands scheduling options and provider choice, opening the door to greater access. Work and family schedules, for instance, can limit the ability of employees to access traditional services provided in an office setting. Through telepsychiatry, employees can schedule appointments in evenings or on weekends in addition to traditional weekday time slots, which reduces absenteeism or tardiness from work.

The reality is that patient satisfaction trends are higher with online psychotherapy as opposed to traditional face-to-face treatment. While telepsychiatry and telebehavioral health are not for every person, this approach to care addresses many of the common barriers to receiving prompt, professional behavioral health treatment that sets the stage for greater overall health and wellbeing.

Employers seeking to achieve the greatest return on health plan investment are wise to consider telepsychiatry and telebehavioral health as means for promoting use of behavioral health benefits. This effective model of care provides the needed framework for improving access to appropriate healthcare resources and empowering employees to take more control of their health.

Telepsychiatry: What to Look for in 2018

By: Geoffrey Boyce

Geoffrey Boyce, Executive Director of InSight Telepsychiatry

Originally published on Behavioral Healthcare Executive

In the world of telehealth, what a difference a few years can make. The industry has moved from burgeoning to mainstream and is seen as a viable model for behavioral healthcare. In fact, industry professional shortages are catapulting adoption and use of telepsychiatry to address unmet psychiatric needs in all states.

The field of telepsychiatry has much to celebrate in recent years, and the outlook ahead is brighter than ever. Here are five top predictions about where telepsychiatry is headed in 2018.

  1. Growth of direct-to-consumer telepsychiatry

Consumerism is taking healthcare by storm as individuals demand greater access, convenience and empowerment in their care choices. It’s why the American Telemedicine Association recently named uptake of consumer-driven technology as one of the top five trends for the telemedicine market in 2018.

Thus, it’s understandable why the “anywhere, anytime” access of telepsychiatry continues to drive growth of direct-to-consumer models. As individuals embrace the ability to access care at home or other comfortable locations where a reliable Internet connection exists, continued evolution of this trend is expected.

Consumers will increasingly recognize the advantages of heightened availability that enables scheduling of sessions outside of traditional office hours. Many increasingly find that video-conferencing models tear down communication barriers and reduce stigma—a key factor that otherwise keeps many from seeking behavioral health treatment. Additionally, individuals can look outside of local referral networks to access services, expanding provider options and consumer choice.

  1. Increased access through policy/legislation and coverage

Perhaps there is no greater confirmation of telemedicine’s positive impact on care delivery than recent policy and legislation developments. The clear majority of states have enacted or proposed some form of parity regarding insurance coverage of telemedicine.

This activity will likely continue as demand for greater access to behavioral health services soars and stakeholders recognize the benefits of telepsychiatry models.

Additionally, in efforts to address the growing opioid epidemic, President Donald Trump earlier this year declared a public health emergency, calling for expanded telehealth access for Americans in need of care. Telehealth is a valuable solution to help improve care and the overall outlook around this significant public health crisis. To ensure that the addiction and mental healthcare disciplines continue to advance and embrace telehealth, and in turn, increase access to much needed services surrounding this crisis, it will be important for states to closely monitor and enact legislation that considers all types of telehealth. For example, language written to curb the prescribing of schedule II drugs via telehealth might extend to the best-practice prescribing of medication for children with ADHD via telepsychiatry, causing unintended limitations.

  1. Positioning for value-based care

The premise of value-based care is higher quality, better outcomes and lower costs. Industry stakeholders increasingly recognize that care delivery must address the whole health of individuals—both physical and behavioral—to achieve sustainable “value.” Individuals are best engaged in their care plans and overall wellness when behavioral health is addressed in tandem with physical illness.

As providers and employers embrace this reality, they are finding that telepsychiatry effectively addresses fragmentation that often exists across the behavioral health continuum. Timely access to behavioral health services—whether emergent or ongoing—improves continuity of care and mitigates the need for higher cost interventions. Especially in multifaceted cases with complex pharmacology, video consultations improve access to multi-disciplinary treatment teams and direct telepsychiatry interventions to improve monitoring and provide ongoing patient engagement.

  1. Increased adoption of connected community models

In synch with positioning for value-based care, healthcare communities will continue to see growth of connected community models in 2018. This will be especially evident in progressive communities that recognize the need for a comprehensive, sustainable and multifaceted behavioral health strategy that increases access to care across the continuum.

For instance, communities will continue to realize notable gains in the coming year by integrating telepsychiatry across multiple settings including:

  • Emergency departments (EDs): ED physicians often lack the psychiatric resources needed for timely evaluations of critical-need patients. Telepsychiatry helps by speeding up access and ensuring quick triage to the most appropriate level of care.
  • Primary care: More than half of all psychiatric drugs today are prescribed by non-psychiatrists due to provider shortages. Telepsychiatrists can provide attractive referral options or a consultative partnership to primary care providers.
  • Community-based care settings: Mental health clinics and other community-based organizations often struggle to retain and recruit local psychiatrists. Telepsychiatry brings long-term access to psychiatry providers who are the best fit for an organization’s needs.
  • Inpatient units or residential program: Inpatient units or residential programs benefit from additional psychiatric support to make sure a unit has 24/7 coverage and consultative support.
  • Medical/surgical floors of hospitals: Medical floors of hospitals often need psychiatric consultations or evaluations to ensure providers are fully treating the patient’s comprehensive health.
  • Discharge planning: Telepsychiatry ensures timely continuation of services for discharge planners in need of referral options, where waiting lists in some clinics can reach upwards of 10 weeks.
  1. New settings embracing telepsychiatry

The industry is also witnessing significant uptake and use of telepsychiatry in areas outside of the healthcare setting as community organizations recognize the advantages. A few examples of new settings include:

  • Community agencies and correctional facilities: These organizations are increasingly engaging with telepsychiatrists to improve access to psychiatric evaluation and treatment.
  • Crisis response teams: mobile mental health crisis teams are leveraged to assist individuals in need, offer assessment and decide the best course of action. By bringing telepsychiatrists with them virtually with a tablet or mobile device, the situation can be assessed and managed in real time.
  • Assertive Community Treatment (ACT) teams: Designed as an intensive and highly-integrated approach, ACT teams support better transitions from hospital environments for individuals who are re-entering the community. Telepsychiatrists can attend home visits along with case managers virtually with a tablet or mobile device.
  • Schools and universities: Young people need convenient, timely access to mental health services, often requiring specialty providers that are difficult to find. Telepsychiatry is a great solution for meeting students where they are with the right resources.

Looking ahead, the opportunities for leveraging telepsychiatry in new settings are endless as communities creatively address behavioral health needs. The telemedicine industry has come a long way in just a few years, and great momentum exists going in to 2018.

 

InSight Telepsychiatry Hosts Webinar on the Implications of the Recently Passed New Jersey Telemedicine Legislation

telehealth advocacy

InSight Telepsychiatry Hosts Webinar on the Implications of the Recently Passed New Jersey Telemedicine Legislation

Marlton, NJ – On December 5th, 2017 InSight Telepsychiatry hosted a webinar titled “What NJ’s Telemedicine Policy Means for Behavioral Health.” The webinar recording can be accessed here.

After viewing the webinar, participants will:

  • Understand what changes for behavioral health care with NJ’s new telehealth policy
  • Look at how new NJ telehealth policy changes how your organization provides care
  • Learn how to provide care in the context of the state’s new policies

The webinar was presented by Geoffrey Boyce, the Executive Director of InSight Telepsychiatry and an advocate for the appropriate use and value of telebehavioral health. Boyce discussed the new telehealth law and how it differs from previous regulation and also reviewed the key aspects of the bill and how they will affect the behavioral health industry and organizations that partner with behavioral health organizations.

Finally, Boyce looked at how the law can be used to expand access to psychiatry, mental and behavioral health care across the care continuum. Attendees will learn how they can use this bill to be active participants in changing the behavioral health industry.

“We’re enthused by the opportunities for improved access to care that this new law brings to the telemedicine industry and to New Jersey,” says Geoffrey Boyce, Executive Director of InSight Telepsychiatry. “We’re happy to share these updates with stakeholders in the field so they can be applied at their respective organizations.”

Over the summer, New Jersey passed the telehealth legislation making it one of the most innovative and supportive telemedicine states in the country. The state is already home to a handful of telemedicine programs, and the new law provides the opportunity for the continued expansion of telemedicine.

About InSight Telepsychiatry

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. More information can be found at www.InSightTelepsychiatry.com.

A Better Approach to Crisis Behavioral Health

Original article published on Becker’s Health IT & CIO Review

Mark Alter, M.D., InSight Associate Medical Director of On-Demand Services

By: Mark Alter, M.D.

Today’s hospital emergency departments (EDs) are facing a perfect storm of behavioral health challenges. A combination of professional shortages and rapid growth in need for behavioral health services is creating significant supply and demand issues across U.S. communities. The overwhelming reality is that 42.5 million Americans struggle with mental health conditions, and professional shortages exist in all 50 U.S. states.

For many communities, the hospital ED has become one of the primary entry points for behavioral health access. Yet, few EDs are equipped with the expertise to handle the scope and complexities of this evolving challenge, leading to lengthy wait times and overcrowding, especially for patients in needs of psychiatric care.

To improve the outlook, hospitals are increasingly turning to the promise of on-demand telepsychiatry—an approach to care providing psychiatric evaluation or consult as needed via videoconferencing. These forward-looking care delivery models not only improve response times and access to services, but they also positively impact patient satisfaction and the bottom line.

The ED Behavioral Health Challenge: A Deeper Look
Current estimates suggest that one in eight ED visits involves a mental health condition, yet patients in need of evaluation often wait much longer than those in need of general medical care. One report found that 23 percent of psychiatric patients had emergency visits that were longer than six hours and 7 percent waited longer than 12 hours—that’s compared to 10 percent and 2.3 percent of other medical patients respectively. In addition, almost 21 percent of patients in need of an inpatient psychiatric bed wait between two and five days.

In terms of adequate staffing for psychiatric issues, today’s hospitals face the same supply and demand issues as consumers in need of services, especially in rural communities, where the existence of even one qualified psychiatrist is often lacking. EDs typically have limited or non-existent in-house hospital expertise available to them, and patients must wait until an appropriate professional is available. These present-day realities lead to crowded ED waiting areas, protracted waits, and the common practice of “boarding” individuals in need of psychiatric evaluation.

The Growing Influence of ED Telepsychiatry Models
Overall, hospital executives are prioritizing telemedicine models to prepare for value-based care. The “2017 U.S. Telemedicine Industry Benchmark Survey” revealed that 51 percent of executives rank deployment and adoption of telemedicine high strategically.

On-demand telepsychiatry models are certainly gaining traction as hospital EDs look to more effectively deliver behavioral health care and address the growing need for services. Provided via video-conference, telepsychiatry providers offer on-call professionals that can be accessed based on need. This framework enables telepsychiatrists to deliver care remotely to numerous organizations at once, increasing efficiency and workflows for all stakeholders.

Credentialed telepsychiatrists first collaborate with ED physicians, nurses and social workers, and review a patient’s medical record. An evaluation is then conducted with a patient in a private area through a computer, tablet or other mobile device. Ultimately, the goal of these one-time encounters is to ensure timely recommendations and triage of patients to the most appropriate level of care. On-demand providers provide valuable consultation services to ED staff and can also prescribe medications directly.

Benefits of on-demand telepsychiatry in the ED include:

Early stabilization and better outcomes
Timely psychiatric treatment initiated in the ED promotes earlier stabilization of conditions and improves patient safety—for both those facing a psychiatric crisis and other patients in the ED. It also ensures patients are triaged to the appropriate level of care or community service.

For instance, it is not uncommon for police officers in some states to bring individuals behaving erratically directly to the ED for psychiatric evaluation. Many of these patients do not require inpatient psychiatric hospitalizations, which can be often be avoided by having timely access to psychiatric professionals who can determine the appropriate level of care.

Many telepsychiatrists also report that patients in crisis situations, particularly those who are agitated or paranoid, can feel less intimidated by video conferencing as opposed to in-person evaluation.

Increased patient throughput
When evaluations are conducted in a timely manner, ED providers can help get patients to appropriate levels of care, opening needed beds to other patients and improving wait room crowding.

Greater patient satisfaction
A combination of timely evaluation and the right expertise ensures a better overall experience for any patients in crisis, including those with behavioral health concerns. When patients are forced to wait for hours or days to see a behavioral health professional, frustration is understandable.

Lower costs
Timely access to care lends to greater efficiencies in the ED and positive bottom-line impacts. In addition, telepsychiatry reduces the need for full-time emergency psychiatrists and ongoing recruitment costs and challenges.

Many hospitals—especially those in rural areas—simply lack the financial resources needed to hire specialized behavioral health professionals to provide services the ED. Additionally, hospitals benefit from the on-demand model by paying for usage as opposed to a full-time equivalent. EDs also reduce liabilities with timely access to on-demand telepsychiatry services, minimizing the potential for litigation that might otherwise occur if conditions escalate and difficult situations arise.

Reduced provider burnout
This approach to care also takes the burden off in-person psychiatric providers who are on call or responsible for covering night-shifts. Telepsychiatrists can work these shifts remotely from another location, even in different time zones, offering added flexibility and an enhanced work/life balance—critical components in addressing provider burnout.

Providing a telepsychiatry resource can also reduce stress on ED directors and other ED providers who do not have the specialty training in psychiatry, but are often faced with treating psychiatric patients.

Future Crisis Behavioral Health Models
While the current outlook on behavioral health professional shortages is grim, the good news is that telepsychiatry holds great promise for filling needed gaps, especially in critical environments such as EDs. Hospitals can realize notable gains by leveraging on-demand telepsychiatry services to improve outcomes, patient and provider satisfaction and the bottom line.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker’s Hospital Review/Becker’s Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

Crisis Behavioral Health Readiness

Behavioral health emergencies affecting whole communities can arise suddenly and can be as unpredictable as the weather. Recent natural disasters such as Hurricanes Harvey, Irma and Maria serve as reminders that all communities are vulnerable to the kind of crisis exposure that turns lives upside down and results in extensive emotional turmoil.

In such situations, the overall readiness of a healthcare provider organization is determined by its ability to respond not only to medical needs but also to psychiatric trauma within its community, with a solid plan of action in place. Implementation and deployment of mobile crisis teams are essential in addressing behavioral health needs at any time, but especially when a disaster strikes. By leveraging telepsychiatry and telebehavioral health within these care models, forward-thinking health systems can help ensure rapid response to mental health needs and the best outcomes.

Community Mental Health Response

To be able to respond quickly to community needs in a disaster, health systems should have dedicated mental health teams in place composed of specially trained professionals who know how to respond to specific mental health issues that develop as a result of a disaster or other community trauma, such as severe destruction or loss of life.

Another way health systems can act to support mental health response in a disaster is through the use of mental health mobile crisis teams. The purpose of such teams should be to intervene with individuals who may be experiencing or are about to experience a mental health crisis in the community by offering real-time support and determining the best course of action for these individuals.

All U.S. states are currently experiencing professional behavioral health shortages, however, making access to needed services and providers a challenge, especially in times of crisis when many people may need help quickly. An effective model for addressing this challenge is the use of telepsychiatry to improve access to care. Such a model also can provide support not only when a disaster hits, but also on an ongoing basis.

Telepsychiatry Advantage

Telepsychiatry allows sessions to be conducted from the anywhere in the community, including individuals’ homes, shelters, and other locations where privacy is possible. Crisis response teams who are deployed in the community can set up consultations with remote telepsychiatry providers on an iPad or other mobile device, allowing individuals in need of immediate evaluation to speak with remote providers on the spot.

Access Services, a not-for-profit organization in Pennsylvania that delivers support services for individuals with special needs, offers an example of how one mental health crisis team is improving its ability to respond to a mental health crisis. In 2014, the organization launched one of the nation’s first models of remote crisis behavioral health care.

According to Brenda Boorse, vice president of digital operations and communications at Access Services, the program reduces the time consumers spend awaiting care and lessens the strain on the psychiatric resources of area hospitals.

“Mobile crisis intervention paired with telehealth is a more immediate support for people,” Boorse says. “It helps resolve the immediate crisis in many cases without unnecessary and costly hospitalization.”

Telepsychiatry can empower local provider resources and elevate readiness strategies by complementing provided services through disaster relief organizations. Although critical to any response strategy, many national disaster relief organizations require a lengthy vetting processes for local behavioral health providers to volunteer their time, which can delay access. Leveraging telepsychiatry provides an effective means of ensuring behavioral healthcare providers will be available in the immediate aftermath of an emergency.

Getting Started

Hospitals or health systems considering a telepsychiatry response program can get started by working with local government officials to conduct a community needs assessment to identify current gaps and opportunities. An organization should look at its existing technological capabilities, define the profile of its population, evaluate the capacity of its existing provider network, make volume projections, identify funding sources, and create action plans around the potential disasters or crises their community may face.

Crisis situations are inevitable across any community, and effective response and remediation often hinges on readiness. Telepsychiatry offers a key resource for addressing the behavioral healthcare needs in emergency situations, and healthcare organizations should consider how to leverage the advantages of this emerging model to meet the mental health needs of their communities.


Geoffrey Boyce is executive director of InSight Telepsychiatry, Marlton, NJ.

Original article published on Healthcare Financial Management Association.

Stewart Memorial Community Hospital Launches Telepsychiatry Program

Lake City, IA – Stewart Memorial Community Hospital, a general medical and surgical hospital with 25 beds, launched a telepsychiatry program this week to increase access to psychiatric care. Located in Calhoun County, Lake City is a rural area with a shortage of mental health professionals, as designated by the Rural Health Clinics Program and the Federal Office of Rural Health.[1]

Telepsychiatry is the delivery of psychiatry through real time videoconferencing. It is proven to be an effective form of care delivery and a great way to expand the psychiatric support at a hospital, especially during difficult to staff hours like nights and weekends.

In a primarily rural state such as Iowa, patients often have limited or no access to timely, affordable and quality care. This is especially prevalent in regards to psychiatric care. With telepsychiatry, emergency departments can efficiently address each patient that comes in, reduce admissions and decrease patient wait times.  Having access to telepsychiatry can also help reduce psychiatric boarding and help make sure that those admitted to psychiatric beds actually need them. This is particularly useful in Iowa which, according to the Treatment Advocacy Center, ranks second worst in the country for number of inpatient psychiatric beds with just 64 in the entire state.[2]

The telepsychiatry program is launched in partnership with InSight, a national telepsychiatry service provider organization. Telepsychiatry services are provided in the emergency department to help ensure patients struggling with mental health issues are properly treated. This gives room for other patients that come into the emergency department that may have potentially life threatening illnesses.

“Partners like Stewart Memorial Community Hospital exemplify the great impact telepsychiatry can have at a community level. Telepsychiatry has been shown to increase access to mental health care in rural areas and we’re pleased to expand that within communities like Lake City,” said InSight’s Operations Director Dena Ferrell.

“Stewart Memorial is always looking to incorporate innovative new programs that help our patients achieve a healthy mind and body. Our partnership with InSight will help better address the behavioral health needs in our community,” said Cindy Carsten, CEO of Stewart Memorial.

Stewart Memorial is served by 13 InSight telepsychiatry providers. All InSight telepsychiatry providers are licensed in Iowa and trained to provide care to Stewart Memorial patients in the same way as all onsite providers. Stewart Memorial’s partnership with InSight will help transform care in the emergency department and increase efficiency so that all patients are able to receive the care they need.

About InSight Telepsychiatry
InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. More information can be found at www.InSightTelepsychiatry.com.

About Stewart Memorial Community Hospital
Stewart Memorial is committed to quality health and wellness for you and your family. Our goal is to transform our communities by providing coordinated care and exceptional experiences.

[1] Rural Health. (n.d.). Retrieved August 07, 2017, from https://www.ruralhealthinfo.org/am-i-rural/report?lat=42.26715&lng=-94.74603&addr=1301 W Main St%2C Lake City%2C IA 51449&exact=1

[2] Fuller, D. A., Sinclair, E., Geller, J., Quanbeck, C., & Snook, J. (n.d.). Going, Going, Gone TRENDS AND CONSEQUENCES OF ELIMINATING STATE PSYCHIATRIC BEDS, 2016. Retrieved August 8, 2017, from http://www.treatmentadvocacycenter.org/storage/documents/going-going-gone.pdf

 

Family Service Launches Outpatient Telepsychiatry Program

Philadelphia, PA – Family Service Association of Bucks County launched an outpatient telepsychiatry program to increase efficiency and access to psychiatric care for adults, children and adolescents across four of their locations in Bucks County, Pennsylvania. The telepsychiatry program is launched in partnership with InSight, a national telepsychiatry service provider organization.

Telepsychiatry is the delivery of psychiatry through real time videoconferencing. It is proven to be an effective form of care delivery and a convenient, cost-effective way to safely expand the psychiatric support without the challenge of staffing an in-person psychiatry provider.family service

Prior to implementing a telepsychiatry program, Family Service staffed an onsite psychiatrist that would travel between Langhorne, Doylestown and Quakertown locations. With telepsychiatry, Family Service was able to increase efficiency and reduce costly, time consuming commutes.

“Telepsychiatry allows organizations like Family Service to reduce commute time for providers and patients. This allows for more valuable time with patients,” said InSight’s Operations Manager of Scheduled Services Nate Ortiz.

It is estimated that 1,051,490 individuals in Pennsylvania are living with serious psychological distress including major depressive disorder, bipolar disorder, panic disorder or anxiety.[1] Telepsychiatry is a great solution in Pennsylvania and in many other states across the nation where there is a shortage of psychiatry providers.

“We are thrilled to be able to offer this innovative new service to our patients. We are dedicated to increasing psychiatric access to all consumers, and this is a smart way to ensure our patients are getting the care that they need on a consistent basis,” said Audrey J. Tucker, Chief Executive Officer.

InSight’s telepsychiatry provider will offer these services to patients in Family Service outpatient behavioral health programs, namely counseling.

About InSight Telepsychiatry

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. More information can be found at www.InSightTelepsychiatry.com.

About Family Service Association of Bucks County

Family Service Association of Bucks County is a nonprofit social service organization with locations throughout Bucks County, Pennsylvania. Family Service’s mission is to listen, care and help. Every day. For more than 60 years, Family Service has been improving the lives of children and their families, doing whatever it takes to help them overcome obstacles and reach their full potential. Visit www.fsabc.org to donate, volunteer or learn more about how Family Service helped more than 27,000 children, teens and adults last year.

[1] National Institutes of Mental Health, National Survey on Drug Use and Health (NSDUH) 2015, and

NSDUH-MHSS 2008-2012.

Digital Health Direct-to-Consumer Telehealth: The Disruptive Solution to the Behavioral Health Provider Shortage

By: Scott Baker, MBA, InSight Business Innovations Manager

The link between behavioral health and medical outcomes is well understood. Providing behavioral health services can help keep some medical conditions in check and prevent hospitalizations and readmissions. However, more than half of US counties are currently without any psychiatrists, resulting in large care gaps and wait times of up to 3 to 6 months. As a result, many patients seek mental health services from primary care providers, who often lack both time and specialized psychiatric expertise to treat such conditions. A more dire situation arises when patients are discouraged from seeking treatment altogether, which can lead to further deterioration or crisis situations.

Amid this provider shortage and growing behavioral health crisis, telepsychiatry is emerging as an effective tool to meet providers’ referral needs. In addition, direct-to-consumer (D2C) telepsychiatry is becoming a more widely utilized treatment option—one that can fill gaps in care at a time when the need for services far outpaces provider supply and address issues before they escalate.

By enabling provider-patient interaction at any time from any location, D2C telehealth helps increase access to care and promotes a more comprehensive response to patient needs, whether physical or behavioral. Making care more convenient often leads to earlier interventions that help ensure patient needs are addressed before issues escalate and require higher-cost interventions.

D2C telepsychiatry: A natural fit for telehealth

The American Telemedicine Association defines telehealth as “the remote delivery of healthcare services and clinical information using telecommunications technology.” The more popular forms of telehealth rely on real-time videoconferencing to deliver services and address patients’ needs, emulating the kind of in-person exchange and connectivity experienced in a provider’s office setting. Continued growth of D2C telehealth underscores the attractiveness of the videoconferencing model, as patients—increasingly empowered in their own care choices—seek direct access to providers and alternative options to more conveniently manage their care.

When it comes to telehealth for behavioral health, telepsychiatry is now used for evaluation, consultation, and treatment throughout the care continuum, and it can be found in settings that range from acute inpatient settings and emergency departments (EDs) to community-based care environments and in-home referrals from primary care doctors and discharge planners.

D2C telepsychiatry takes the burden off primary care providers and expands referral options in areas lacking adequate psychiatric services. With additional providers available, patients are empowered with greater choice, rather than limited by what is within a drivable radius. Beyond primary care providers, community-based professionals such as referral coordinators, benefit managers, and discharge planners can leverage this option to help consumers access qualified behavioral health specialists in a timely manner.

Collaborative care between telepsychiatry providers and patients’ primary care and regular providers can also extend the value proposition of D2C telepsychiatry by improving coordination, increasing clinical exchanges and connecting a patient’s community of caretakers for more holistic care.

The advantages of D2C

D2C telepsychiatry delivers inherent advantages for both patients and providers, including:

Flexibility. Consumers can schedule appointments outside of traditional weekday time slots, including nights and weekends, and can often find available appointments within a few days of their request.

Convenience. Services can be accessed from any private location leading to better continuity of care. For example, consumers can continue treatment with the same psychiatric provider during life transitions, such as moving to a new city for college.

Privacy. Like in-person care, telepsychiatry protects the privacy of patients. In fact, confidentiality may be heightened since appointments are accessed from home, eliminating the potential that patients will see someone they know in a waiting room—a concern that keeps many from seeking out treatment.

High-quality care. Telepsychiatry meets the standard of traditional in-person care for diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. Along with all major national healthcare associations, the American Psychiatric Association supports the use of this model.

Implementing telepsychiatry

Healthcare organizations interested in utilizing D2C telehealth and telepsychiatry should, of course, consider situational nuances prior to determining the best course of treatment. Conditions such as anxiety, depression, stress, life transitions, childhood mood disorders, and ADHD align well with D2C telepsychiatry. However, it is not appropriate for patients who display suicidal, homicidal, delusional or paranoid symptoms.

In addition, providers should keep in mind that while most people have access to reliable internet connections and smart devices that can support telepsychiatry, not everyone has this luxury. Prior to making referrals, providers should assess a patient’s ability to follow through with the telepsychiatry option.

The potential of D2C telepsychiatry

D2C telehealth models, and specifically telepsychiatry, represent a disruptive care delivery movement that is laying the groundwork for a more connected community and collaborative care continuum. By improving access, these forward-thinking models of care promote early intervention, addressing issues before they escalate and require higher-cost interventions. Ultimately, it’s an optimal framework for improving outcomes and empowering consumers in their care.

Original article posted in Oliver Wyman Health.

InSight Telepsychiatry Expert Presents Grand Rounds at Deborah Heart and Lung Center

BROWNS MILLS, NJ – Dr. Jim Varrell, InSight’s Medical Director spoke at the Deborah Heart and Lung Center in Brown Mills, NJ during grand rounds. Dr. Varrell gave a presentation on applications of telepsychiatry in hospital settings to an audience of doctors, residents and other behavioral health professionals.

Deborah Heart and Lung Center is a specialty hospital that sees heart and lung patients and has no emergency department. Deborah Heart and Lung Center is also a partner of InSight, where they utilize telepsychiatry on their medical floors.

Dr. Varrell’s presentation gave an in-depth outline of telepsychiatry, which included topics such as:

  • Overview of telepsychiatry
  • Telepsychiatry use in hospitals
  • How to set up a telepsychiatry program
  • Technological setup
  • Clinical workflow
  • Telepsychiatry regulations
  • Clinical best practices and case studies

“Our work at InSight has given us access to all the ins and outs of delivering behavioral healthcare via telemedicine,” said Dr. Varrell. “It is an honor to impart the knowledge we’ve gained from years of experience in the field, to a new generation of healthcare professionals.”

Dr. Varrell and other InSight leadership often present during grand rounds to educate medical professionals on the importance and best practices of telemedicine and its ability to increase access to quality care.

About InSight Telepsychiatry

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists. More information can be found at www.InSightTelepsychiatry.com.

About Deborah Heart and Lung Center

The Deborah Vision means continuing to be the premier provider of cardiovascular and pulmonary services in the region. We will be known for excellent clinical outcomes and for supreme customer-driven service, and as the ultimate leader in patient safety and privacy. We will continue to partner with other quality providers and payers to ensure a seamless continuum of care to the patients we serve. We will continue to improve both service and quality in the most cost effective manners. This is our uncompromising standard of care.

InSight Brings Telepsychiatry Services to the Yellowstone County Detention Facility

BILLINGS, MT – Located in south central Montana, Yellowstone County is Montana’s most populous with an estimated 144,797 residents in 2009, according to the Montana Department of Commerce. The Yellowstone County Detention Facility brings six hours a week of InSight telepsychiatry services to their inmates from Psychiatric Nurse Practitioner, Renée Brunner Houser.

Renée Brunner Houser, PMHNP, MSN is a Montana licensed psychiatric nurse practitioner who has worked as a psychiatric nurse practitioner and registered nurse in a variety of settings such as psychiatric hospitals, inpatient/outpatient health centers, hospice facilities and public schools. InSight will provide first time evaluations, follow up care, medication management and more.

According the National Alliance on Mental Illness, at least 83% of jail inmates with a mental illness did not have access to needed treatment. In addition, telepsychiatry is found to improve access to mental health services for inmates and save correctional facilities from $12,000 to more than $1 million [1]. InSight brings years of experience in correctional facility psychiatric care to serve Yellowstone’s inmates and increase access to care when they need it the most.


[1] Deslich, S. (2013). Telepsychiatry in Correctional Facilities: Using Technology to Improve Access and Decrease Costs of Mental Health Care in Underserved Populations. The Permanente Journal,17(3), 80-86. doi:10.7812/tpp/12-123

Telepsychiatry Long-Term Partnership a Continued Success

InSight Telepsychiaty and NewPoint Behavioral Healthcare Continue to Reduce Emergency Department Wait Times with Telepsychiatry for 15 Years

MARLTON, NJ — After 15 years of service, InSight Telepsychiatry and NewPoint Behavioral Healthcare continue to provide successful telepsychiatry services to individuals requiring emergency behavioral healthcare.

Winona InSight

As a New Jersey designated screening center, NewPoint Behavioral Healthcare provides behavioral health services such as emergency assessments, crisis intervention and referrals to inpatient psychiatric organizations.

The services offered by NewPoint Behavioral Healthcare combine traditional treatment options with telepsychiatry. When an individual enters a screening center during a psychiatric crisis, an on-site behavioral health screener conducts an initial assessment. The screener then meets with an InSight provider through phone or videoconference to determine diagnosis and treatment options. This could include admission, prescribing of medication or referral to follow-up care.

“NewPoint Behavioral Healthcare screeners truly develop a strong rapport with InSight’s providers,” says InSight’s Director of Operations Dena Ferrell, who worked as a behavioral health screener for the organization prior to joining InSight in 2007. “InSight providers really enjoy a friendly and productive working relationship that adds value to this partnership,” she added.

The partnerships success is exemplified through conducting over 200 telepsychiatry sessions in 2015 alone. “We use telepsychiatry 24/7 and most feel just as satisfied as they are with face-to-face psychiatrist sessions,” said Vikki McFadden, NewPoint Behavioral Healthcare’s Clinical Coordinator of Psychiatric Emergency Screening. “Before we were able to utilize telepsychiatry clients in other emergency room settings would sometimes wait days to be sent to the screening host,” McFadden added.

“The technology has gotten better,” says Jennifer Plews, NewPoint Behavioral Healthcare’s Director of Psychiatric Emergency, describing how telepsychiatry used to be delivered on a heavy cart with a monitor versus a cart that can now be easily pushed with one hand.

As one of InSight’s longest partnerships, NewPoint Behavioral Healthcare has seen firsthand how telepsychiatry has evolved. With a mission to provide a spectrum of quality services to maximize individual potential through education and empowerment, NewPoint Behavioral Healthcare has served communities in New Jersey for nearly 60 years through more than 16 outpatient behavioral health programs offering effective, affordable psychiatric screenings.

About InSight Telepsychiatry

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists. More information can be found at www.InSightTelepsychiatry.com.

About NewPoint Behavioral Healthcare

The mission of NewPoint Behavioral Healthcare is to provide a spectrum of quality services to maximize individual potential through education and empowerment. NewPoint Behavioral Healthcare is committed to be the leader of quality mental health services in the region.

Telepsychiatry: Raising the Bar on Access to Mental Health Care

By Dr. James Varrell, Telepsychiatrist and Medical Director of InSight

As May—Mental Health Awareness Month—rolls around each year, health care stakeholders are reminded to reflect on the notable achievements and strides made in mental health treatment. The industry continues to forge new paths in terms of technological advancement, research, discovery and awareness, leading to a more holistic approach to care delivery and improved health outcomes across U.S. communities.

In terms of improving access to care, one advancement in particular carries significant weight for expanding care options and lowering costs for patients, providers and communities: telepsychiatry. Telepsychiatry is a form of telemedicine that uses videoconferencing to provide psychiatric evaluation, consultation and treatment. A growing segment of telepsychiatry is direct-to-consumer care, which is working to tear down stigma-related barriers to treatment and open doors to expanded referral options and more timely care. In fact, industry stakeholders increasingly recognize direct-to-consumer telepsychiatry as a primary solution for filling mental health care gaps at a time when the need is soaring.

In tandem with the goals of value-based care, today’s patients and providers are no longer willing to settle for limited mental health treatment choices within their community. Similarly, communities should no longer view the long waits traditionally associated with accessing psychiatric care as acceptable, especially when telepsychiatry lays the foundation for more optimal, timely care delivery.

Recognizing the Need for Greater Access

Today’s mental health landscape is characterized by an increased need for services coupled with a dwindling supply of psychiatrists. The reality is that 42.5 million Americans struggle with mental health conditions including stress, depression, anxiety, relationship problems, grief, mood disorders and other psychological concerns. Unfortunately, accessing effective treatment is not easily attainable given the following statistics:

  • More than 55 percent of U.S. counties are currently without any psychiatrists.
  • The mental health landscape is facing shortages in more than 4,600 areas.

In addition, referrals to community-based psychiatrists often have an average 3-6 month wait time—a fact that is especially true for specialty psychiatrists, such as those who have expertise in complex child conditions. To put this need into perspective, the number of child and adolescent psychiatrists in New Jersey would need to triple to adequately support the need in that state alone.

Primary care doctors are often sought out as a resource for filling these service gaps created by growing demand. Yet, many may be uncomfortable prescribing medication for mental health disorders or lack specific expertise on psychotropic medications.

Consider the following scenario:

A 53-year-old female has a history of refractory depression and has tried numerous antidepressant options through her primary care doctor, who is at a loss as to the correct formula for the patient’s needs. The patient’s history reveals that she has had discrete hypomanic episodes, characterized by sudden displays of energy, productivity and noticeably more creativity. These 1-2 week episodes were followed by a decline back to her usual depression. Looking for a second opinion regarding her care, her primary care doctor referred the patient to a telepsychiatrist.

When the telepsychiatrist reviewed her symptoms he made the conclusion that the patient has type two bipolar disorder and needed an appropriate medication regiment.

Fortunately, in this example, the patient suffering from type two bipolar disorder accessed the needed psychiatry expertise in a timely manner by using direct-to-consumer telepsychiatry. After an accurate diagnosis and subsequent follow-up visits with the telepsychiatrist, the patient’s medications were further adjusted, resulting in effective management of the disorder and a satisfied patient.

The Telepsychiatry Advantage

Direct-to-consumer telepsychiatry introduces notable opportunities to improve access to care. Through live, interactive communication with a licensed psychiatrist in a private setting of the patient’s choice, this treatment model diminishes many of the existing challenges to reaching patients in need.

For instance, patients who live in remote areas where mental health services are lacking have access to psychiatry expertise within a few days rather than several weeks or months. Also, stigma becomes less of an issue as patients are able to experience more privacy, and care is more conveniently accessed in the home or a private location.

Appointment scheduling options outside of traditional office hours address the roadblocks of busy lifestyles that are often a deterrent to consistent follow-up and treatment. In tandem, mental health providers can see more patients with this increased flexibility. Direct-to-consumer telepsychiatry can also support greater continuity of care. For instance, some patient populations, like teens and college students, are more willing to continue treatment if a relationship is maintained with the same psychiatric provider during life transitions like moving to a new city for college.

Telepsychiatry is clinically proven to deliver high-quality care that meets the standard of traditional in-person care for diagnostic accuracy, treatment, effectiveness, quality of care and patient satisfaction. Along with the majority of medical associations, the American Psychiatric Association supports the use of telepsychiatry as long as it is used in the best interest of the patient and complies with medical ethics and federal privacy and security regulations. For these reasons, telepsychiatry is increasingly becoming reimbursable by a number of insurance plans.

Forward Looking

Going forward, the industry must embrace the promise of direct-to-consumer telepsychiatry as a critical strategic component to improving access to care. Telepsychiatry is a viable option and an alternative to traditional in-person care for mental health issues that has the potential to better serve communities and improve population health.

Original story published in HIT Leaders & News.

St. Joseph’s Villa Receives Telehealth Innovation Award

Telehealth Innovation Award from the Mid-Atlantic Telehealth Resource Center recognizes effective use of telepyschiatry in the Villa’s Crisis Stabilization Unit.

RICHMOND, VA — St. Joseph’s Villa (SJV) of Richmond, VA received the prestigious Telehealth Innovation Award from the Mid-Atlantic Telehealth Resource Center (MATRC). The award recipients were announced on April 3, 2017 during the 2017 MATRC Telehealth Summit. The award is given to organizations that demonstrate an innovative application of telehealth and contribute to improved health outcomes and/or quality of life in the Mid-Atlantic region.

SJV partners with InSight to bring telepsychiatry to children receiving mental health services at their facility. One of SJV’s many innovative and effective programs is their Crisis Stabilization Unit (CSU), where children experiencing mental health crises can receive treatment in an environment that feels like home — all with the goal of preventing costly, unnecessary hospitalization. Since opening in 2012, the CSU has served nearly 500 children and has successfully diverted nearly 90 percent of them from hospitalization. InSight has helped the CSU work toward this goal for nearly two years with the help of telepsychiatrist Dr. Ashika Kapoor.

As one of the first crisis stabilization units for children and adolescents in Virginia, and one of the first crisis stabilization units in the country to use telepsychiatry, St. Joseph’s Villa exemplifies how combining modern technology and a personal touch can offer a meaningful and potentially life-changing service to patients and families in their time of need. The Villa is able to help children and families through a difficult time in their lives and provide them with opportunities to succeed because they have a telepsychiatry provider.

“St. Joseph’s Villa is committed to providing high quality behavioral health services to children and their families in innovative new settings. Our partnership with InSight has allowed us to expand our provider capacity,” said Kathleen Burke Barrett, CEO of St. Joseph’s Villa.  “We’re delighted that our efforts to provide care beyond the confines of an office were recognized by MATRC.”

Telepsychiatry allows children in the CSU to see psychiatry providers through videoconferencing. It has been proven an effective and cost-conscious way to bring psychiatric care to children and many other populations.[1]  With the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to staff in rural and underserved areas. When the CSU opened in partnership with the Richmond Behavioral Health Authority (RBHA) Region IV, SJV found that it was challenging to locate a qualified local child psychiatrist. In terms of mental health providers, several of the counties SJV’s CSU serves are Designated Health Professional Shortage Areas, according to the U.S. Health Resources and Services Administration.  Ultimately, SJV turned to telepsychiatry as the solution for bringing psychiatric care to their facility.

“InSight prides itself on developing partnerships with innovative, like-minded organizations and works hard to find the right fit between our telepsychiatry providers and our partners,” says Geoffrey Boyce, Executive Director of InSight. “Congratulations to St. Joseph’s Villa on this accomplishment and we look forward to sustaining a productive partnership.”

About InSight Telepsychiatry

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists. More information can be found at www.InSightTelepsychiatry.com.

About St. Joseph’s Villa

Established in 1834, St. Joseph’s Villa is the longest serving nonprofit for children in the country.  The Villa impacts 3,000 children and families each year facing homelessness, autism and developmental disabilities, mental illness, and other challenges.  Villa programs help them believe in themselves while providing them with the tools they need for long-term independence, stability, and success. For more information, visit www.NeverStopBelieving.org.

[1] Myers, K. M., Valentine, J. M., & Melzer, S. M. (2008). Child and Adolescent Telepsychiatry: Utilization and Satisfaction. Telemedicine and EHealth, 14(2), 131-137. doi: 10.1089/tmj.2007.0035

InSight Executive Director Speaks at Telemental Health Briefing on the Hill

WASHINGTON—On Tuesday, March 28, InSight Telepsychiatry’s Executive Director, Geoffrey Boyce, appeared as a guest speaker at the American Telemedicine Association’s (ATA) briefing, ‘Telehealth for Improving Mental and Behavioral Care.’

Boyce TCC

The briefing was part of ATA’s Telehealth Capitol Connection series—a bimonthly Congressional briefing for policy makers, federal agencies, national organizations and other interested stakeholders.

Boyce spoke after telemental health advocate, Rep. Tim Murphy (R-PA), about four telemental health topics—licensing, credentialing, psychiatric commitment law and prescribing—and how policies around those topics shape how InSight and other telemental health providers can deliver services.

“Telehealth is absolutely a keystone in mental health care because it allows a way to mend the shortage of providers, and provide easier and timely access for inpatient admissions and emergency care,” said Murphy. “It also just makes sense in cost savings.”

Telemental health services are growing rapidly. The VA health system estimates that they conducted 427,000 telemental health sessions in 2016 while InSight Telepsychiatry estimates conducting 150,000 telepsychiatry encounters last year.

Telehealth is addressing critical issues in the behavioral health field, such as shortages in mental health professionals, the challenge of remote care delivery, and, national struggles with suicide, PTSD, opioid addiction and other serious behavioral health issues. Some of the common settings for telemental health services are in hospital emergency departments, outpatient clinics, correctional facilities and direct-to-consumer.

“One of the things we as a practice get most excited about is the potential for telehealth to weave all of these different types of health services and sites together to really help provide care across the continuum, and have more consistency and continuity in that care,” said Boyce.

InSight is a telebehavioral health practice that began telepsychiatry encounters in emergency departments in 1999. Since then, the practice has grown to 250 providers who provide services in 27 different states in a variety of settings. Boyce leads InSight in their mission to increase access to behavioral health care by overseeing the operation of hundreds of U.S. locations every year.

Boyce was joined by fellow speakers: Rep. Tim Murphy (R-PA), John Peters, Telehealth Deputy Director at the Department of Veteran Affairs, Deborah C. Baker, J.D., Director of Legal & Regulatory Policy in the Office of Legal & Regulatory Affairs at the American Psychological Association’s Practice Directorate, and Lauren McGrath, VP of Public Policy at Centerstone.

The briefing was held at Top of the Hill Banquet & Conference Center in Washington, D.C. at 12:00 p.m.

Telepsychiatry: Reaching More Patients For Better Outcomes

By Dr. Jim Varrell, Medical Director, InSight Telepsychiatry

(Originally Published 3/17/17 on Health IT Outcomes)

A 42-year-old woman with chronic anxiety and agoraphobia found herself unable to leave her apartment. She reached out to her primary care doctor who prescribed Xanax, but the medication was only making her feel worse. Unable to go out in public, she found a telepsychiatry provider who adjusted her medication and dosage, connected her with cognitive behavioral therapy, and helped her reclaim her life.

Health IT Outcomes Every year, about 42.5 million Americans struggle with mental illness — enduring stress, depression, anxiety, relationship problems, grief, mood disorders or other psychological concerns. Despite the availability of treatment most people don’t get the help they need, not necessarily due to stigma or denial, but because they can’t: it’s inconvenient or mental healthcare providers aren’t available in their area or within the time frame they need an appointment. To increase access to behavioral healthcare, people need an alternative to traditional doctor referrals, and telepsychiatry can help. Telepsychiatry is a type of telemedicine that uses videoconferencing to provide psychiatric evaluation, consultation, and treatment.

A Growing Market
A key driver of telepsychiatry is the serious shortage of psychiatry providers and other mental health professionals in the U.S. Today there are more than 4,600 mental health professional shortage areas making it difficult, if not impossible, for patients to access services. People referred to psychiatry providers by their primary care doctors face long and potentially dangerous wait times — often three to seven months or longer.

The situation is even worse for those in need of specialty providers, such as child and adolescent psychiatry providers. Currently, there are only about 8,200 practicing child and adolescent psychiatry providers nationally. To put this in perspective, New Jersey alone would need three times as many practitioners as it now has to adequately support the number of children in the state.

Telepsychiatry also offers the promise of delivering more effective mental healthcare in primary care practices. The burden of mental healthcare often falls on primary care doctors, yet many are unable to provide the most appropriate behavioral health resources. Adequately assessing and treating behavioral health issues requires more time with the patient than many doctors or nurse practitioners are able to spend. Moreover, while it is perfectly acceptable for primary care doctors to not know the ins and outs of mental healthcare, many don’t feel equipped to treat behavioral health conditions themselves because they lack specialized training. But without referral options, primary care doctors are often forced to do so. Many practices are overwhelmed with changes in how care is delivered and reimbursed, and under pressure to maximize time with patients, making it difficult for doctors to do it all.

Meeting Behavioral Healthcare Needs

Quality: Telepsychiatry is leading the way in telemedicine for delivering high quality care that meets the standard of traditional in-person care. The American Psychiatric Association supports the use of telepsychiatry as long as it is used in the best interest of the patient and complies with medical ethics and federal privacy and security regulations. It supports the patient-doctor relationship required by law to prescribe medications with documentation — a process identical to the traditional outpatient setting. For these reasons as well, it is increasingly reimbursable by insurance plans.

Continuity of care: In addition to meeting care standards, telepsychiatry positively impacts continuity of care by providing greater accessibility to psychiatry providers. It meets patients where they are. Many patient populations including children, college students, and veterans respond well to this form of treatment, especially since they can maintain the relationship with their same psychiatric provider regardless of location. Other studies have found telepsychiatry can positively impact care for seniors and nursing home residents, reducing costs for the facility as well as improving access to needed care. Age has not been found to be a barrier to acceptance and most seniors readily accept the format.

Access to care: Telepsychiatry is one of the most effective ways to increase access to care for individuals who might otherwise go without. Providing access to specialists for people in rural and remote areas is a challenge. Telepsychiatry offers a practical and cost-efficient way for psychiatry providers to reach these patients. The logistical benefits extend to those in urban centers as well. In light of the dramatic provider shortage, resources are scarce in all settings driving up wait times and commutes to be seen in-person. Telepsychiatry allows existing behavioral health providers to see more people at more flexible times. Many providers who offer telepsychiatry services do so during off-hours to meet the needs of consumers who have trouble finding time for commutes and waiting rooms, or who have trouble leaving their homes.

Cost-effective: Behavioral health issues cost $135 billion every year — almost as much as heart disease and cancer treatment combined. Telepsychiatry can help lower costs for both psychiatry providers and their patients. Studies have found telepsychiatry incurs fewer direct and indirect costs than in-person services saving on provider time, medical supplies, technology, and reimbursement, as well as costs associated with the clinical space, administrative support, travel, and time off work. Nowhere is this savings more pronounced than in the rural setting where telepsychiatry has been found to reduce costs by as much as 40 percent. For hospitals and inpatient residential programs required to provide patients with follow-up care options, telepsychiatry can help ensure a seamless care transition with proactive post-discharge outreach, reducing potential penalties for providers under value-based care.

A Solution For Better Outcomes
Telepsychiatry meets patients’ needs for convenient, flexible, and accessible mental health services, helping improve patient outcomes. The convenience of online appointments makes patients more likely to attend their behavioral health sessions than if they were seeing a provider in person — and when people are consistent in managing their behavioral health, their physical health also improves. It also gives patients more options to find the right provider for them and the care that meets their specific needs, and allows typically underserved groups to access care. This combined with less travel time, less time off work and shorter wait times for services means people get the care they need sooner, are more engaged in their health and happier with their experience of care.

About The Author
James R. Varrell, M.D. has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry.

New Jersey Awards Virtua $290,000 to Serve Veterans Via Telehealth

Trenton, NJ – The New Jersey Department of Health announced a $290,000 telehealth grant to Virtua Health on January 27 that will assist veterans who need access to primary and behavioral healthcare services but may face mobility or transportation challenges.

By coordinating care with Oaks Integrated Care, Legacy Treatment Services and InSight Telepsychiatry, Virtua will offer primary and behavioral health visits conducted via online technology starting February 1.

Stigma, negative ideas about seeking help, perceptions of the Veterans Administration (VA) and a lack of access due to geography and transportation issues make it difficult for veterans to visit a doctor in person. Some medical conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), brain injury, spinal cord injury and other psychiatric disorders further complicate the ability for travel. 

“For many veterans, travel to see a healthcare provider can be complicated and overwhelming, particularly in areas where transportation options might be limited,” Health Commissioner Cathleen Bennett said. “Telehealth can ease the burden by offering long-distance virtual care to veterans while they remain in a comfortable environment.”

Telehealth includes telepsychology, telepsychiatry, telebehavioral health, e-counseling, e-therapy, online therapy and cybercounseling. If veterans have other needs such as housing, employment or transportation, Virtua will seek to connect them to appropriate services.

One in five homeless Americans are veterans. One in three homeless men are veterans, and about 60 percent of homeless veterans are minorities. Veterans of Iraq and Afghanistan have an unemployment rate approximately 40 percent greater than the general population.

Veterans have disproportionate rates of mental illness, particularly PTSD, substance abuse disorders, depression and anxiety. Nearly half of combat veterans from Iraq report that they have suffered from PTSD, and about 40 percent of these veterans report problems with alcohol use.

Follow the New Jersey Department of Health on Twitter at twitter.com/NJDeptofHealth and on Facebook at facebook.com/NJDeptofHealth.

InSight Telepsychiatry Supports Creativity and Innovation During Psychiatry Innovation Lab Event

Oct. 19, 2016 | InSight Telepsychiatry was proud to support three awards during the Psychiatry Innovation Lab at IPS: The Mental Health Services Conference organized by the American Psychiatric Association.

Washington, D.C. — InSight Telepsychiatry awarded three finalists for innovative ideas in the advancement of behavioral health care during the Psychiatry Innovation Lab at IPS: The Mental Health Services Conference organized by the American Psychiatric Association.

Chaired by psychiatrist and author Dr. Nina Vasan, the Psychiatry Innovation Lab is an educational workshop that fosters the advancement of health care delivery. The lab offers the opportunity for professionals in technology, business, medicine, government and nonprofits to connect and collaborate with psychiatrists and mental health professionals.

On Oct. 8, participants pitched ideas for the advancement of behavioral health care delivery by way of entrepreneurship, policy, systems redesign, education, collaboration, technology and more. InSight awarded a total of three of the six awards presented at the event.

A team of neuropsychiatry-minded high school students was awarded Outstanding Progress for their work on AlzHelp, an augmented-reality and intelligent personal assistant app that keeps individuals living with Alzheimer’s disease safe. The app was designed by Akanksha Jain, Michelle Koh and Priscilla Siow.

Presented by mental health care entrepreneur April Koh, Spring.com was awarded the Most Promising Innovation for enabling the prediction of treatment outcomes for depression by way of machine-learning and big data.

The last award supported by InSight went to a group called Beacon led by Shrenik Jain for the Most Disruptive Innovation. Beacon is a mobile application for chat-based group therapy that has participated in a diverse selection of health care technology initiatives. A consistent group of anonymous users come together in judgement-free communities with this group therapy app.

Other winners included: The grand prize winner Joseph Insler for his “overdose recovery bracelet” and the audience choice Swathi Krishna for SPECTRUM, an app for children with autism spectrum disorder.

As the leading national telepsychiatry organization, InSight is proud to support a workshop that cultivates the advancement of behavioral health care through innovative applications of technology. InSight provides psychiatric care through innovative applications of technology by providing telepsychiatry services to hospitals, outpatient clinics and other health care organizations nationwide.

New Psychiatric Practice in New York Allows Individuals to Get Their Mental Wellness On(line)

Telebehavioral health allows individuals to attend sessions with behavioral and mental health providers online through secure videoconferencing. Inpathy is a division of InSight Telepsychiatry, the largest telebehavioral health organization in the nation.

Inpathy providers include adult and child and adolescent psychiatrists and psychiatric nurse practitioners that are available for psychiatric assessments, medication management and prescriptions when appropriate. Therapists and counselors are also available for talk therapy sessions through telehealth.

Many of the Inpathy telebehavioral health providers offer night and weekend appointments, which can be accessed through the internet from home using a smartphone, tablet or a computer with a webcamera. This makes managing behavioral health care more convenient by eliminating the need to travel to in-person appointments and sit in waiting rooms. Another benefit of telebehavioral health is that it is a more private way to access behavioral health services, which makes it a good option for individuals who are worried about a stigma on behavioral or mental health care.

Just like in an in-person office, the telebehavioral health providers who deliver services through Inpathy are fully supported by a clinical and administrative staff that handles their scheduling, billing, intake, general operations and clinical oversight.
Inpathy accepts insurance from several major insurance companies, including Aetna. For in-network telebehavioral health sessions, individuals are only charged their co-pay just like they would be for an in-person session. Inpathy providers are also available for out-of-network and cash-pay appointments.

“There is a huge shortage of psychiatrists across the nation,” says Geoffrey Boyce, executive director at InSight. “Telepsychiatry and telebehavioral health offer a unique solution for making psychiatry appointments easier to book and attend.”

Inpathy has telebehavioral health appointments available with many New York-licensed providers, including the following:

  • Doug Ikelheimer, MD- an extremely experienced telepsychiatrist with expertise in the psychopharmacologic management of mood disorders, anxiety disorders, chronic mental illness and addictions
  • Catherine Newton, LCSW – a licesnsed clinical social worker who specializes in working with individuals who have experienced trauma and is trained in Eye Movement Desensitiazation and Reprocessing (EMDR)
  • Ragy Girgis, MD – a board certified psychiatrist with an interest in the psychopharmalcologic management of schizophrenia, mood disorders, anxiety disorders and eating disorders in adults
  • Hinna Shah, MD – a board certified adult and child and adolescent psychiatrist with experience working with individuals who have depression, bipolar disorder, anxiety disorders, autism spectrum disorder and ADHD
  • Liz Espinoza, LCSW – a Spanish-speaking licensed clinical social worker who is interested in helping individuals achieve life goals and specializes in anger management, relationship, communication and life transition issues

Telehealth is a rapidly growing industry and more and more insurance companies and providers are offering this form of care. Numerous studies have shown telebehavioral health to be as effective as in-person behavioral health services in most situations.

To get started as an individual using telebehavioral health care, individuals can visit http://www.inpathy.com to search the Inpathy provider directory, sign up, select an appropriate provider and schedule a session. Inpathy has a 24-hour technical support line and care navigation team that can be reached at 1.800.442.8938.

InSight is also in the process of developing referral relationships with a number of New York organizations that could benefit from additional behavioral health services for their clients. To learn more about this or connect individuals you know to care, visit http://www.inpathy.com.

Cathy Newton

Hawaii Teens Go Off-Island for Counseling: Any Other Options?

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June 2, 2016 | A report shows Hawaii teens seeking mental health treatment often have to leave the island to find it. What are patients in other remote areas trying?

By Lucy Schouten

Scott Shimabukuro, a clinical psychologist in the Hawaii Department of Health's Child and Adolescent Mental Health Division, and Lynn Fallin, deputy director of behavioral health, pose at the Hawaii Department of Health offices in Honolulu on May 24. Dozens of mentally ill teens are sent to the mainland for treatment each year because they can’t find the proper services in the islands. (Marina Rikder/AP)

Scott Shimabukuro, a clinical psychologist in the Hawaii Department of Health’s Child and Adolescent Mental Health Division, and Lynn Fallin, deputy director of behavioral health, pose at the Hawaii Department of Health offices in Honolulu on May 24. Dozens of mentally ill teens are sent to the mainland for treatment each year because they can’t find the proper services in the islands. (Marina Rikder/AP)

Many patients in rural or remote areas of the country must travel long distances to meet with a counselor or receive mental health treatment, but some young patients face a much more burdensome trip by plane or boat.

Some Hawaii teenagers have faced such long waits for treatment that healthcare providers send them to the mainland, reports the Associated Press. This takes them away from the support of friends and family, leaving authorities looking for strategies employed by other communities.

An ongoing shortage of mental health providers, especially for those trained to work with specific populations such as adolescents or veterans, has strained public health resources in many communities throughout the United States – especially in rural areas.

Noting the lack of mental healthcare options in many remote areas, the US Department of Agriculture has invested $50 million in rural mental health access, especially for veterans, part of an overall strategy to integrate more mental health services into primary care, to which rural patients have better access.

In some communities, local leaders are being trained to recognize when someone may be in need of immediate mental health services. The Mental Health First Aid course, originally developed in Australia but adapted by the health departments of Maryland and Missouri, trains rural community and faith leaders to recognize signs that a patient is suicidal or in need of other help and to identify counseling resources.

“The course helps participants to not only gain confidence in their capacity to approach and offer assistance to others, but also to improve their personal mental health,” reported the US Department of Health and Human Services after investigating the program.

A 21st-century solution, the growing practice of telepsychiatry, enables patients in remote or underserved areas to meet with counselors over live video stream. The new practice followed telemedicine – where doctors might remotely check a patient’s heart rate – but telepsychiatry shows more promise, Kristine Crane reported for US News and World Report.

Designed for patients whose remote residency limits their access to counselors, telepsychiatry can give patients at busy community hospitals the help they need without adding to patient rolls in already overburdened emergency rooms. In South Carolina, where most therapists live in or near the capital, a 2009 pilot study turned into an ongoing practice. Psychiatrists now have about 400 remote consultations per month, saving $1,400 per episode.

Such remote counseling does have disadvantages, as counseling sessions require a secure connection because of privacy laws, and it makes a “human touch” impossible.

“A caring touch or handing a patient a tissue can never be possible,” noted Hind Benjelloun, a crisis psychiatrist based in Washington, D.C., who meets with some patients via computer, in an interview with US News and World Report. “I am unable to clearly see self-inflicted wounds or tears.”

But where face-to-face counseling isn’t possible, virtual therapy can help fill a much needed void, proponents say.

“In a more rural area, nobody has access [to psychiatric care],” Geoffrey Boyce, executive director of InSight Telepsychiatry, told US News and World Report. “[Telepsychiatry is] enormously more affordable at that point.”

 

View this story on The Christian Science Monitor.

St. Joseph’s Villa and InSight Telepsychiatry Bring Psychiatric Care to Children in Crisis Stabilization Unit

April 19, 2016 | St. Joseph’s Villa of Richmond, Va. works with InSight Telepsychiatry to bring telepsychiatry services to their Crisis Stabilization Unit, an innovative program in a unique setting that diverts children in mental health crisis from unnecessary hospitalization.

RICHMOND, Va. — St. Joseph’s Villa is collaborating with InSight Telepsychiatry to bring telepsychiatry to children receiving mental health services at their facility. St. Joseph’s Villa (SJV) provides children and their families with a variety of social services. One of SJV’s many innovative and effective programs is their Crisis Stabilization Unit (CSU), where children experiencing mental health crises can go to receive treatment in an environment that feels like home — all with the goal of preventing costly, unnecessary hospitalization. Since opening in 2012, the CSU has served nearly 500 children and has successfully diverted nearly 90 percent of them from hospitalization. InSight has helped the CSU work toward this goal for nearly two years.

Located in a repurposed cottage with spacious bedrooms and recreation areas, SJV’s CSU’s six-bed facility acts as a hybrid between a residential home and a hospital. This hybrid model allows SJV to offer clinical services, including telepsychiatry, while giving children in crisis a less restrictive environment than that of traditional residential treatment centers.

A first-of-its-kind facility in central Virginia, the CSU was a runner up in the Innovative Practices Award presented by the Council on Accreditation to spotlight organizations that bring lasting change to the lives of vulnerable individuals through unique, forward-thinking initiatives.

Telepsychiatry allows children in the CSU to see psychiatry providers through videoconferencing. With the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to staff in rural and underserved areas. When the CSU opened in partnership with the Richmond Behavioral Health Authority (RBHA) Region IV, SJV found that it was challenging to locate a qualified local child psychiatrist. In terms of mental health providers, several of the counties SJV’s CSU serves are Designated Health Professional Shortage Areas, according to the U.S. Health Resources and Services Administration.1 Ultimately, SJV turned to telepsychiatry as the solution for bringing psychiatric care to their facility.

Telepsychiatry isn’t just a means of bringing access to care. The telepsychiatry medium is able to help these children express themselves better, says Craig Hedley, SJV’s Director of Community Partnerships. “Kids are used to Skyping, but they can be intimidated by adults. Children can relate to them better through a TV screen, which provides them a layer of safety and protection,” he says.

The CSU collaborates with an InSight telepsychiatrist for about 15 hours a week of regularly scheduled services. The telepsychiatrist, Dr. Ashika Kapoor, helps onsite providers assess children’s symptoms and manage their medications.

“There are unique challenges to working at a crisis stabilization unit, but I really enjoy being a part of a team approach,” Dr. Kapoor says. “The staff at St. Joseph’s Villa are a wonderful group of individuals who do amazing work together as a team.”

According to Hedley, Dr. Kapoor is a flexible asset to this team-oriented approach and goes out of her way to help the team help the children for which they care.

“Dr. Kapoor is extremely invested in our program,” Hedley says. “Her responsiveness is incredible.”

The relationship between the InSight telepsychiatry provider and onsite staff is vital to the success of SJV’s CSU program.

“InSight believes in the importance of partnering with innovative, like-minded organizations and working hard to find the right fit between our psychiatrists and our partners,” says Geoffrey Boyce, Executive Director of InSight. “Integrating Dr. Kapoor onto the St. Joseph’s Villa CSU team has been a wonderful success.”

InSight Telepsychiatry is the leading national telepsychiatry service provider with a mission to increase access to appropriate behavioral health care. Telepsychiatry has been proven an effective and cost-conscious way to bring psychiatric care to children.2 Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists.

“The partnership between InSight and St. Joseph’s Villa shows how we can combine modern technology and personal touch to offer a meaningful and potentially life changing service to patients and families in their time of need,” says Dr. Kapoor. “Together we are able to help children and families through a difficult time in their lives and provide them with opportunities to succeed.”

 

[1] http://datawarehouse.hrsa.gov/tools/analyzers/HpsaFind.aspx

[2] Myers, K. M., Valentine, J. M., & Melzer, S. M. (2008). Child and Adolescent Telepsychiatry: Utilization and Satisfaction. Telemedicine and EHealth, 14(2), 131-137. doi: 10.1089/tmj.2007.0035

Defining Behavioral Health

Behavioral health is the scientific study of the emotions, behaviors and biology relating to a person’s mental well-being, their ability to function in every day life and their concept of self. “Behavioral health” is the preferred term to “mental health.” A person struggling with his or her behavioral health may face stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders, or other psychological concerns. Counselors, therapists, life coaches, psychologists, nurse practitioners or physicians can help manage behavioral health concerns with treatments such as therapy, counseling, or medication.

The Difference Between Behavioral Health and Mental Health

Many people are more familiar with the term, “mental health.” Mental health covers many of the same issues as behavioral health, but this term only encompasses the biological component of this aspect of wellness. The term, “behavioral health” encompasses all contributions to mental wellness including substances and their abuse, behavior, habits, and other external forces.

What is Psychiatry?

Psychiatry is the practice of diagnosing and treating behavioral and mental health disorders. This includes creating personalized treatment plans around an individuals’ disorder that can include medication, therapy, counseling, CBT, alternative medicines or any combination of these. Psychiatry is practiced by specially trained doctors or nurse practitioners depending on state law.

If you’re interested in learning more about behavioral health, behavioral health providers, or specific behavioral health issues you can check out these resources:

What to Consider When Choosing a Provider

Choosing Behavioral Health

Understanding Stigma

Choosing Behavioral Health Care

If you think that you or someone you care for may benefit from psychotherapy or another form of behavioral health treatment, the best place to start is with your primary care provider. Discuss your symptoms with them and ask them if it would be best for you to pursue care from a specialized psychiatry or therapy provider. They usually will have a list of organizations they partner with for in-person care, but you can always discus online care options with telehealth providers, like Inpathy.

You can also schedule a session with a behavioral health provider directly through a number of online resources and tools. Websites like ZocDoc.com and Healthgrades.com both have extensive databases and profiles of providers across the United States. Many insurance companies have databases of physicians who take their insurance, along with short profiles. You can also meet with a psychiatry or therapy provider directly from home using online video calls, which may be a good option if finding time to schedule an appointment is usually a daunting and stressful process. You can read more about the telehealth option InSight offers here.

Spend time with these resources reading through profiles and considering what you’re looking for in a provider. Perhaps there’s a specialty you’d like to look into like child and adolescent or addiction psychiatry? Maybe you’re interested in learning more about a type of therapy, like cognitive behavioral therapy, and you’d like to find a provider who specializes in it. Check out the Types of Providers page for more information on the different kinds of behavioral health providers.

Whatever source you choose to find a provider, you should meet in person with at least two or three providers before deciding on who you’d like to see regularly. Make it clear with each provider initially that you are identifying options and that this is an early stage in your journey. Meeting with multiple providers will give you a chance to compare what you do and do not like about each, allowing you to make a more informed choice overall.

Ask questions. When meeting with a new provider, ask them questions about their practice and specialties. Here are a few sample questions to ask:

  • How long have they been in practice?
  • How much experience do they have with clients like you? With your specific issues?
  • What kind of training did they receive?
  • What kind of approach to treatment do they prefer?

The Bottom Line:
Above all else, you are a consumer of services in this matter. Do not be intimidated by the idea of seeking professional help, or think that because these are specialists, they are infallible. Providers are human beings too, and some will be a better fit for you than others.

Telepsychiatry Leader Predicts Major Industry Changes

Telepsychiatry, or psychiatric care provided through real-time videoconferencing, is a widely used medium for bringing psychiatric care into locations with limited access to mental health professionals. Telepsychiatry is allowing individuals to access behavioral health services like never before.

In this white paper, telebehavioral health leader James R. Varrell, M.D. details exciting developments he foresees for the telepsychiatry industry.

Download this white paper.

Other Telebehavioral Health Services

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In addition to psychiatry, InSight can offer all other levels of behavioral health services through telehealth. InSight has a large network of behavioral health providers including counselors, therapists, social workers and psychologists who we work with to service the comprehensive behavioral health needs of any organization or individual, all through telehealth. With InSight’s Inpathy division, individuals can directly access these professionals from the comfort and convenience of their own homes or other private spaces. Insurance companies, employers and EAPs can also partner with InSight to offer Inpathy behavioral health services to members or employees.