Tag Archives: psychiatry

Telehealth: Transforming Child Mental Health Care

By: Jeanine Miles, LPC

Original article published on NAMI

Unprecedented need exists for child and adolescent mental health services in today’s communities, however, parents have limited options at their disposal. Shortages of child psychologists and psychiatrists are leaving our most vulnerable populations without care. Currently, all U.S. states are facing high or severe shortages, with many communities lacking even one qualified child and adolescent psychiatrist.

We need an effective solution, and it might be telebehavioral health. This convenient, accessible model of care has been gaining traction: Studies consistently reveal high satisfaction rates for children, adolescents and parents, often reaching above 90%. In fact, a 2013 studydetermined that telebehavioral health might be better than in-person care for children and adolescents because this age group often expresses an unwillingness or reluctance to participate in traditional therapy sessions.

Telebehavioral health might be a natural solution for improving access to care, but that’s just one benefit. As a counselor who offers telesessions, I’ve seen many more. Consider the following:

Comfortable Surroundings

Clinical office settings often intimidate children and adolescents. I find that younger populations are more willing to open up when they are in their own environment surrounded by familiar possessions or in reach of pets who may offer comfort. With telebehavioral health, I also get clues and information from a home environment I never see in an office setting.

For example, one child was well-behaved during our traditional office appointments. Yet her mother described a very different child with erratic behaviors while at home. Through our telebehavioral health sessions, I could see family interactions that confirmed the mother’s assessment. I was then able to teach the young girl and her family healthy coping techniques right there “at home.”

Familiar Modes Of Communication

Younger generations have grown up with technology. In fact, a 2015 study shows 67% of teens own a smartphone and spend more than four hours daily engaged with it. Videoconferencing, therefore, is a natural fit for today’s youth. Many teens prefer telesessions compared to traditional office sessions because it’s familiar and helps build trust. Simply put: Today’s youth are more comfortable communicating through a screen.

Easier Scheduling

One of the greatest barriers to engaging younger populations in mental health treatment is stigma. Many adolescents fear their peers will find out they go to therapy and ask questions. Professional shortages and scheduling challenges often causes students to miss school to attend therapy sessions. When a student leaves school early or checks in late, their peers may ask questions or make them feel uncomfortable.

With telebehavioral health, scheduling becomes much easier, as sessions can take place outside of traditional office hours. Patients do not have to miss school, nor do they run the risk of running into someone they know in a waiting room.

When choosing a telebehavioral health care organization or provider for your child, it’s important to do research before pursuing treatment. Things to consider are whether or not they are HIPAA-compliant, if they offer technical or care navigation support, whether they have providers licensed in your state, and if you can pay with your insurance plan. A good place to start is a reference guide, such as the one created by Open Minds that lists reputable telebehavioral health organizations.

Telebehavioral health care is changing the way communities and families approach mental health services. At a time when the need for mental health care is soaring, this option holds great promise for addressing gaps in care and providing parents with a critical resource for addressing their child’s health and well-being.

 

Jeanine Miles, LPC, Cognitive Behavioral Therapist with Inpathy and the Director of Business Development and Training at the Center for Family Guidance. Jeanine is a New Jersey Licensed Professional Counselor and has over 20 years of administrative and management experience in healthcare and behavioral healthcare. She is responsible for the development and implementation of new programs including overseeing all start-up projects, social skills training and school based programs. Jeanine has provided therapy and other telebehavioral health services through Inpathy since the program was launched and has long been an advocate for telebehavioral health.

 

 

Delaware Takes Its ACT to the Next Level

A Delaware ACT team conducts a weekly briefing with its telepsychiatrist.

Delaware is known as the “First State” since it was the first colony to ratify the United States Constitution, but that motto can also apply to another bold step undertaken in the state more recently. A few years back, Delaware became the first state to merge telepsychiatry with assertive community treatment (ACT).

Two teams managed by the nonprofit Resources for Human Development (RHD) have been using telepsychiatry since 2014. The teams are known as RHD Kent ACT2 and RHD New Castle ACT2 and are based in Dover and Wilmington, respectively.

For some, it may seem an odd pairing. A core aspect of ACT—a proven therapy for severe mental illness such as schizophrenia—is the idea of face-to-face contact. Multidisciplinary ACT teams meet with patients both in clinics and in their communities (at home, at work while on lunch break, or at another similar location in the community) to help patients recover and reintegrate into society.

Could this model still work if the ACT psychiatrist was present via an iPad or similar device?

“I had some concerns about telepsychiatry coming in, since I thought many clients wouldn’t want to talk to a television, but it has not been a problem at all,” said Shelley Sellinger, M.D., a New York–based psychiatrist and mental health consultant for the Kent ACT team. “A couple of patients had some wariness initially, but they warmed quickly. I even had one patient with television-related paranoia, but he was totally fine with the arrangement.”

Laura Marvel, director of RHD Kent ACT2, agreed. “It doesn’t matter if the psychiatrist is in person or on a screen,” she told Psychiatric News. “If we have access to a good doctor, it doesn’t matter where the doctor is.”

The incorporation of telepsychiatry was born out of necessity. In 2012, Delaware awarded ACT contracts to RHD to help provide better outpatient care to people with severe mental illness such as schizophrenia. RHD found out quickly that getting psychiatrists involved was difficult given the time commitments; in addition to traveling across the state to make scheduled or emergency house visits, ACT team members meet weekly to discuss patient progress.

Around that time, Dan Khebzou, an account executive with the telepsychiatry firm InSight, was meeting with RHD administrators in Philadelphia to discuss service options. He heard about the difficulties RHD was having in hiring psychiatrists for the newly formed ACT teams and suggested the telepsychiatry option.

“I’ve encountered resistance in using telepsychiatry for vulnerable populations from regulators; they cite issues such as licensing, technical problems, or handling civil commitments through video,” said Khebzou. “But Delaware was willing to embrace telepsychiatry, so it presented an opportunity to prove this model.”

After a successful pilot program, RHD moved full steam ahead with telepsychiatry in 2014, and the program is still going strong today, Marvel said. Besides patient acceptance, she said that other ACT team members—which include case coordinators, nurses, and social workers—are on board with the technology. They have not seen Sellinger’s participation via video during their weekly team meetings as hindering the team dynamic.

If anything, Sellinger said, the remote aspect can help build some relationships with the team. “I can conduct most assessments remotely as well as in person, but there are elements that are difficult, such as testing AIMS (Abnormal Involuntary Movement Scale) or rigidity,” she said. “In these cases, the on-site nurses are my eyes and ears, and we communicate about what’s going on. In addition, they will let me know about hygiene if it’s pertinent, so they also are my nose.”

There are occasional technical glitches as well, but Marvel said the teams have established back-up plans to reach Sellinger in case of some malfunction with the video monitor used in the clinic or the iPad used on the road. “I’ve found Dr. Sellinger is as accessible to me or the team as an on-site person would be,” she said. “Sometimes even more so; maybe there is a sense of overcompensating since she can’t be physically present.”

“ACT is a wonderful way to provide care to persistently ill folks who might not be able to get care otherwise,” Sellinger said. “However, it is a demanding job to go into communities every day and work with these individuals, and it can lead to psychiatrist burnout. This telepsychiatry model has allowed me to continue to practice and give care longer than I might have otherwise.”

Original article published on Psychiatric Times

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

 

InSight Telepsychiatry Experts Present Psychiatry Grand Rounds at Western Michigan University Homer Stryker, M.D. School of Medicine

KALAMAZOO, MI – Representatives from InSight Telepsychiatry participated in a grand rounds presentation for the Department of Psychiatry at Western Michigan University Homer Stryker, M.D. School of Medicine. This was the first time the School of Medicine held a presentation on the topic of telepsychiatry.

The presenters were Randy McCloud and Dillon Euler, M.D. McCloud has a decade of diverse healthcare experiences and extensive clinical knowledge of behavioral health, in addition to experience designing and implementing successful telepsychiatry programs. Dr. Euler has focused his career on public and community psychiatry, forensic psychiatry and administrative consulting. For the past two years, Dr. Euler has worked in emergency telepsychiatry and is very interested in improving access to and quality of psychiatric care in various communities.

In their presentation entitled, How to Make Telepsychiatry Work, McCloud and Dr. Euler discussed

  • How telepsychiatry is used
  • The benefits of utilizing these kinds of services
  • Different models of telepsychiatry
  • The best practices for organizations and providers when using telepsychiatry.

As an appropriate demonstration of telemedicine’s technological capabilities, Dr. Euler joined via videoconference and shared a clinical case study demonstrating the strengths of telepsychiatry care in practice.  Those in attendance were left with a few “Telepsychiatry Takeaways” to remember as they continue their work in the behavioral health field.

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.

The Psychiatrist Shortage in Virginia

By James Varrell, MD

HOW TELEPSYCHIATRY CAN HELP

Due to trends in mental health advocacy and growing clinical evidence, people are increasingly recognizing the benefits of psychiatry and behavioral health care. For example, a 2012 study published in Contingencies measured the cost of a single employee’s depression over a two-year period prior to that employee receiving depression treatment and found the cost to the business to be as high as $3,386 per affected employee.

Unfortunately, even with a cultural shift towards addressing mental illness in Lynchburg, employers and families are struggling to get convenient and timely access to care due to a significant shortage of psychiatrists. According to the National Alliance on Mental Illness, there are over a million Virginians who experience mental illness and about 300,000 of those illnesses are classified as serious. Even with 930 psychiatrists licensed in Virginia, there simply aren’t enough providers to go around. As a psychiatrist, the demands for services can be overwhelming.

Moreover, because most psychiatrists are concentrated in Virginia’s urban pockets (Northern Virginia, the Richmond metropolitan area and Hampton Roads) many individuals outside of these areas endure long commutes to reach the nearest psychiatrist who has available appointment times. Oftentimes, getting care for oneself or a family member can be off-putting and stressful.

How Telepsychiatry Can Help
Telepsychiatry is a growing and clinically effective way to provide psychiatry, mental and behavioral health care to individuals through online video calls. Telepsychiatry can be used to provide psychiatric evaluations, consultations and treatment to individuals in various settings including outpatient offices, correctional facilities, hospitals, emergency departments, crisis centers or even in homes.

Facility-based telepsychiatry has a decent foothold in the healthcare industry. Today one of telepsychiatry’s newer applications, direct-to-consumer (D2C) telepsychiatry, is quickly becoming popular. D2C telepsychiatry allows providers to give psychiatry, mental and behavioral health care to people directly in their homes or any other private space. This takes away the stress of commuting to and from in-person offices. It also means that the time individuals and their families spend getting care is shortened to only the duration of the session, making it easier to fit into a busy schedule.

An Individual’s Experience with D2C Telepsychiatry
For example, one of my patients, whom I will call Anna, suffers from severe anxiety and depression. As a result of her disorder, Anna struggled to leave her home, and her husband, Rick, often had to take time off of work to accompany her to appointments with her psychiatrist whose office was 50 minutes away.

The stress of her appointments made Anna’s symptoms worse, negatively impacted Rick’s work and put additional strain on their family life.

It was in their search for a better care solution that Anna started to receive psychiatric medication management from me and therapy from one of my colleagues all through telepsychiatry. Anna started to access her sessions from home in the evenings after her children had gone to bed. Using telepsychiatry allowed her to receive treatment independently and the reduced stress of receiving care has empowered her and helped her to better cope with her disorder.

The Benefits of D2C Telepsychiatry

Anna’s experience is one that is shared by many Virginians who struggle to find a convenient psychiatry or behavioral health solution for themselves or their loved ones. Here are some of the many ways people can benefit from D2C telepsychiatry:
• Convenience. People can schedule appointments outside of traditional weekday hours and can easily attend sessions using any computer, tablet or smartphone in any private space with a reliable internet connection.

• Increased access to care. Telepsychiatry expands choices for providers and specialists beyond those who are within driving distance. Any provider nationwide who is licensed in the individual’s state can offer services to them. Practicing online means providers can spend more time treating people instead of traveling between offices.

• High-quality care. With more providers to pick from, people can choose the one who best fits their personality, needs and schedule. Reputable D2C telepsychiatry programs will have their providers trained to deliver telehealth appropriately and effectively.

• Privacy. Telepsychiatry is safe and secure. Some individuals prefer seeking care from the privacy of home without the fear of running into a nosy neighbor in the waiting room.

Not only does this type of treatment make it possible for people like Anna to receive care in a comfortable environment, but it also removes stress from their work and personal relationships. Telepsychiatry improves lives and is an excellent tool for increasing access to psychiatry and behavioral health care in Virginia communities.

Original story posted in Lynchburg Business Magazine.

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.

Live & Practice: Small Towns and Cities

(Original story published in PracticeLink Magazine—Spring 2017)

Marlton, New Jersey

Just 30 minutes from Philidelphia, 90 minutes from New York City and 2 hours from Baltimore, Marlton is popular among people who want to be near family in one of these major geographic areas while enjoying a small-town lifestyle. Marlton has strong community spirit, with several annual festivals sponsored by local government and scores of free exercise facilities, family activities and classes such as yoga and karate for residents.

Small towns and rural areas sometimes present a challenge for health care providers. That was the case when a rural southern New Jersey community first contracted with CFG Health Network, which is based in Marlton.

The community asked CFG to cover its psychiatry needs. But a week before the contract was to begin, there was a new requirement: all physicians had to be able to get to the facility within an hour of getting a call.

To continue reading, click here.

PracticeLink article

 

 

Billings Clinic is now Bringing After-hours Psychiatric Care to its Emergency Department and Inpatient Unit Through Partnership with InSight Telepsychiatry

Jan. 17, 2017 | Billings Clinic of Billings, Montana, has partnered with InSight Telepsychiatry to bring after-hours telepsychiatry services to their emergency department and inpatient unit, an innovative program which will ensure individuals in need of psychiatric treatment at Billings Clinic will have access to timely, quality care.

BILLINGS, MT — Billings Clinic, Montana’s largest healthcare organization, and InSight Telepsychiatry are pleased to announce a new partnership to increase inpatient and emergency psychiatric coverage.

The program is designed to lessen wait times for psychiatric evaluations, admission, and treatment decisions.  The partnership gives Billings Clinic staff access to a team of remote psychiatrists who can do psychiatric evaluations, follow-up consultations and medical consultations through telehealth using video calls. Nurses and emergency department physicians can now connect patients with a remote telepsychiatry provider in as little as an hour.

The telepsychiatry program runs from 10 p.m. to 8 a.m., 7 days per week. Since, psychiatric emergencies often happen at night or on weekends, this schedule means that individuals in crisis are able to get the care they need more quickly.

The program is a result of a partnership between Billings Clinic and InSight Telepsychiatry, the leading national telepsychiatry organization and partner of MHA Ventures, a subsidiary of the Montana Hospital Association. Montana, like many other states across the country, struggles to have sufficient psychiatric coverage in its hospitals and clinics due to a national shortage of psychiatrists.

At nearly double the national average, Montana has the highest suicide rate in the United States with more than 23 suicides per 100,000 people[1]. Additionally, over 75% of Montana’s population has inadequate access to psychiatry[2]. So with the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to recruit in rural and underserved areas.

“Really, the best thing about a program like this one,” says InSight’s Medical Director Jim Varrell, MD, “is that Montanans now have access to psychiatric services where they may not have had previously.”

”This partnership is another step for Billings Clinic toward improving mental health care for people in crisis,” said Lyle Seavy, Billings Clinic Director of Psychiatry, “We are addressing those peak times when staffing is a challenge to help meet the needs of our patients, help reduce strain on our staff and help improve the experience for people in a mental health crisis.”

As a result of the partnership, the telepsychiatry program is expected to expand into additional Billings Clinic facilities.

In addition to facility-based models of telepsychiatry, InSight is also working with the Montana chapter of Mental Health America to offer telemental health care to individuals in their home or other private spaces online.

About Billings Clinic

Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, Billings Clinic is governed by a board of community members, nurses and physicians. At its core, Billings Clinic is a physician-led, integrated multispecialty group practice with a 285-bed hospital and Level II trauma center. Billings Clinic has more than 4,000 employees, including more than 400 physicians and advanced practitioners offering more than 50 specialties. More information can be found at www.billingsclinic.com.

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.

 


[1] Suicide: Montana 2016 Facts and Figures. (2016). In American Foundation for Suicide Prevention. Retrieved January 12, 2017, from https://afsp.org/about-suicide/state-fact-sheets/#Montana

[2] Mental Health Care Health Professional Shortage Areas (HPSAs). (2016, September 8). In Kaiser Family Foundation. Retrieved January 12, 2017, from http://kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0

InSight Telepsychiatry Presents at American Academy of Child and Adolescent Psychiatry Annual Meeting

October 28, 2016 │ InSight Telepsychiatry was proud to present on the legal, regulatory and financial realities of telepsychiatry at the American Academy of Child and Adolescent Psychiatry’s 63rd Annual Meeting.

New York, NY – InSight Telepsychiatry’s Executive Director, Geoffrey Boyce, and Medical Director, Dr. Jim Varrell, presented at the American Academy of Child and Adolescent Psychiatry’s (AACAP) 63rd Annual Meeting held in New York City. The AACAP annual meetings are a gathering place for leaders in the field of child and adolescent psychiatry, children’s mental health and other allied disciplines.

Boyce and Dr. Varrell’s presentation, entitled Legal, Regulatory and Financial Realities of Telepsychiatry, was delivered during the “Road Map to Establish and Sustain a Telepsychiatry Practice” clinical breakout session organized by Dr. Kathleen Myers and attended by over 100 child and adolescent psychiatrists. Their presentation covered topics including models of telepsychiatry, reimbursement, licensure, the provider-patient relationship and emergency protocol. Other presentations during this breakout session included Media Training to Develop and Authentic Patient-Doctor Relationship presented by Dr. David E. Roth and Competencies in Telepsychiatry: Residency Training and Maintenance of Skills presented by Dr. Daniel A. Alicata.

Additionally, Dr. Varrell presented on the entrepreneurial side of telepsychiatry during the breakout’s TED-talk style session. He discussed being a thought leader in telepsychiatry and telepsychiatry best practices. Dr. Varrell has been providing telepsychiatry services since 1999 and is one of the founding members of InSight Telepsychiatry, the national leading telepsychiatry service provider.

Boyce and Dr. Varrell also took part in the breakout session’s ‘Genius Bar.’ They hosted a “Careers in Telepsychiatry: Choose Your Own Adventure” station where attendees were encouraged to ask them questions about what a career in telepsychiatry looks like. Telepsychiatry provides a unique opportunity for psychiatric providers because it allows them to work from home, extending their hours to nights and weekends.

Geoffrey Boyce is the Executive Director of InSight Telepsychiatry and an active participant in telemedicine advocacy, education and reform initiatives.

Jim Varrell, MD is the President and Medical Director of the CFG Health Network and InSight Telepsychiatry who has been at the forefront of telepsychiatry across the nation and continues to educate the medical community regarding the benefits of telepsychiatry.

InSight Telepsychiatry is the national leading telepsychiatry provider organization with a mission to increase access to behavioral health care.

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.

InSight Telepsychiatry to Present at American Telemedicine Association Annual Conference

May 15, 2016 | InSight Telepsychiatry leaders, providers and partners are presenting this week at the American Telemedicine Association’s Annual Conference and Trade Show in Minneapolis. Their presentations, which will address practicing telebehavioral health in a variety of settings and marketing telebehavioral health to consumers, will draw on InSight’s experience as the leading national telepsychiatry service provider organization.

MINNEAPOLIS — Representatives from InSight Telepsychiatry will give presentations on a variety of telepsychiatry topics during the American Telemedicine Association’s (ATA) Annual Conference and Trade Show May 15 to 17.

On May 17, two InSight providers will present during one of ATA’s 75+ peer-reviewed sessions. The session, called How-To Telemental Health in Non-Institutional Settings, will feature “Fast-Paced Work from the Comfort of Home: Clinical Considerations for Crisis Telepsychiatry,” presented by Doug Ikelheimer, MD and “ACT Now for Innovation: Develop a Telemental Health Program for ACT Teams,” presented by Shelley Sellinger, MD.

Dr. Ikelheimer, a board-certified psychiatrist, will draw on his experience as an InSight on-demand telepsychiatry provider to discuss the benefits of challenges of working in an emergency department (ED) from home.

On-demand telepsychiatry providers offer much-needed psychiatric expertise that can reduce the amount of time consumers in crisis wait for proper care. Dr. Ikelheimer’s presentation will review the steps that need to be taken to establish a successful emergency telepsychiatry program and examine case studies in which individuals were able to receive timely, appropriate care through telepsychiatry in emergency departments.

Dr. Sellinger, also a board-certified psychiatrist, will present a case study that details InSight’s partnership with Resources for Human Development (RHD) to establish a telepsychiatry program with mobile capabilities for two assertive community treatment (ACT) teams in Delaware. The program is the first in the nation to use telepsychiatry in an ACT program and serves as a model for implementing telepsychiatry into ACT programs nationwide.

The program brings a combination of on-site and in-home telepsychiatry services to individuals whose mental health conditions prevent them from working or living independently. With 4G-enabled tablets and laptops, RHD social workers to travel to individuals’ homes or other community spaces to connect them with a remote psychiatry provider.

Laura Marvel, the Unit Director for RHD’s Delaware assertive community treatment teams, will present alongside Dr. Sellinger.

InSight Marketing and Communications Manager Olivia Boyce will present the e-poster, “Telemarketing: It’s Not What You Think — A How-To Guide for Promoting Direct-to-Consumer Telehealth,” on May 15.

Additionally, InSight Business Innovations Manager Scott Baker will moderate the session, “Effectiveness of Automated Speech Recognition Apps,” on May 17. The session will focus on the use of speech recognition apps in behavioral health services, including telepsychiatry.

ATA 2016 is the industry’s leading event for insights into the latest telemedicine and mobile health trends.

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through innovative applications of technology.

For more information and to connect with InSight at ATA, visit booth 1909 or booth 515, where InSight will exhibit alongside Carenection, a telehealth marketplace that offers a scalable, unified telemedicine solution for organizations and systems implementing telehealth. To schedule a time for a meeting, contact Olivia Boyce at oboyce@in-sight.net or 770.713.4161.

Telepsychiatry and Mental Health

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April 20, 2016 | By Joshua Kendall

See the original article at Undark.org.

Patients who cannot access mental health services — or who are not comfortable seeking help — increasingly do so remotely.

In the wake of the Gulf oil spill in 2010, many rural Louisiana residents became emotionally distressed. With few mental health clinicians practicing in the area, psychiatrists at Louisiana State University decided to try something novel. They set up a video connection between their New Orleans office and small primary care clinics in towns like Hackberry, which sits over 200 miles away and has a population of just over 1,000.

“I treated several crabbers and shrimpers from Hackberry who couldn’t work, were falling into debt and were very depressed,” said Dr. Shih Tan Gipson, a psychiatrist at Boston Children’s Hospital who recently completed her residency at LSU. “With regular therapy sessions, along with medication, I was able to help them get their lives back on track.”

This approach, known as telepsychiatry, has been around for more than a half a century; in 1959, the State of Nebraska used two-way closed-circuit television between the Nebraska Psychiatric Institute and the state mental hospital to aid in the teaching of first-year medical students. Advances in technology over the last 20 years have made telepsychiatry systems much easier to set up and it is now starting to be widely adopted.

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Telepsychiatry allows patients who cannot access mental health services or are not comfortable seeking help to consult with clinicians via videoconferencing.

The U.S. Department of Veterans Affairs, which began experimenting with ‘telemental health’ in 1995, has been a pioneer in using this method. The VA has already administered over 2 million video mental health sessions with patients and the pace continues to pick up every year. In 2015, 380,000 sessions were conducted using video. At present, about 8 percent of all mental health patients at the VA use telemental health. The VA is now beginning to expand beyond its hub model — in which therapists treat patients at hundreds of community-based clinics across the country — to using phones and tablets.

“We treat patients with every type of DSM-5 diagnosis,” said Dr. Linda Godleski, a professor of psychiatry at Yale and director of the VA’s National Telemental Health Center.

Surveys show that patient satisfaction with this method is about 95 percent. In addition to being able to reach patients in underserved areas and provide easy access to national experts, telemental health has other advantages as well.

“Patients with severe disorders such as schizophrenia often feel more relaxed and are more likely to open up,” Godleski said.

Telemental health has also proved to cut health care costs. In a 2012 survey published in the journal Psychiatric Services, Godleski showed that access to telemental health service reduced hospitalization admissions of VA patients by about 25 percent.

Not everyone embraces the idea that mediated interactions between clinicians and patients are always beneficial, or that they function similarly to in-person therapy. In her 2015 book “Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy,” British psychotherapist and psychoanalyst Gillian Isaacs Russell, PhD., for example, raised questions about the loss of certain non-verbal cues, and pointed to the lack of research comparing the various pros and cons of both in-person and screen-mediated therapy.

Still, most clinicians believe that the technology is now good enough to enable them to spot many standard non-verbal cues, and some states, including New York, have begun to establish formal telepsychiatry standards and guidelines.

While the private sector has been much slower to take advantage of this new technology, the industry leader, Insight Telepsychiatry, which has been in operation since 1999, reports steady growth. In 2015, it had 150,000 patient encounters — a 50 percent increase over 2014. The company now offers services to hospitals and community mental health clinics in 26 states, compared to the nine states it operated in just three years ago.

This year, the American Psychiatric Association set up a telepsychiatry committee, which works to break down two major obstacles to broadening its scope. One involves licensure: Clinicians must be eligible to practice in the same state in which their patients reside. The other involves reimbursement, given that in some states, insurance companies provide little or no coverage. The APA is currently working with doctors in various other fields to make it easier for clinicians to obtain licenses in multiple states. To date, 12 states have signed on to the Federal State Medical Board Interstate Licensure Compact which provides an expedited pathway to licensure and another 14 have introduced similar legislation.

“In 10 years, telepsychiatry may well become a core component of psychiatric care,” said Dr. Peter Yellowlees, a member of the APA committee who teaches psychiatry at the University of California, Davis. “For people under 40, connecting with therapists on screens seems both reasonable and normal.”

See the original article at Undark.org.

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

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.