Remote treatment was a way of life for the mind during the epidemic. What is happening now?

Visual sessions make it easier for people who are depressed or anxious to keep appointments. But video calls have also created new challenges.


When the Covid-19 epidemic forced private healthcare providers to stop seeing patients in person and instead of holding treatment sessions remotely, the device produced an unintended, positive outcome: Few patients skipped appointments.

That has always been a problem in mental health care. Some patient illness programs previously did not have as many shows as 60 percent, according to several studies.

Only 9% of psychiatrists report that all patients maintain their pre-epidemic duration, according to a report by the American Psychiatric Association. Once providers have switched to telepsychiatry, that number has risen to 32 percent.

Not only that, but providers and patients say that teletherapy has always been an appropriate lifestyle for people dealing with anxiety, depression and other mental health problems during an extremely difficult time, even if it creates new challenges.

Many providers say they plan to continue providing teletherapy after the epidemic. Some states are permanently enforcing epidemic laws that allow providers to reimburse you for the same amount of visits, which is acceptable news for insurers.

"We are in a state of mental health crisis right now, so many people have a problem and may be open to accessing resources," said psychologist Allison Dempsey, a associate professor at the University of Colorado School of Medicine in Aurora. "It's very easy to connect from your living room."

The problem for absentee patients was often as simple as canceled travel, said Jody Long, a clinical social worker who learned a 60 percent chance of not being shown or canceled late at a psychiatric clinic at the University of Tennessee Health Science Center.

But sometimes it was a health problem in itself. He remembers a long time ago seeing the first patient walk through the parking lot and get out. The patient later called and told Long, “I can't get out of the car; please forgive me and arrange a date for me. ”

Long, now an assistant professor at Jacksonville State University in Alabama, said the incident changed his mind.

"I realized that if you have a panic attack or a panic attack or you suffer from severe depression, it is difficult," she said. "It's like you built these defensive walls and suddenly you had to lower these walls."

Unemployment care providers and their supervisors set targets for billing and production and those who work independently who lose paid hours, said Dempsey, who oversees a program to provide mental health care to families of children with severe medical problems. Psychiatrists often book patients in the hope that some will not show up, he said.

Now Dempsey and his colleagues no longer need to book too much. When patients are not seen, staff can sometimes contact the patient immediately and hold a session. At times, they may even have to rearrange themselves on that day or on a different day.

And telepsychiatry also works, if not better, the face-to-face delivery of mental health services, according to a review of the World Journal of Psychiatry for 452 studies.

Visual visits can also save patients money, as they may not need to travel, take a break from work or pay for child care, says Dr. Jay Shore, chairman of the American Psychiatric Association's telepsychiatry committee and psychiatrist at the University of Colorado medical school.

Shor began exploring the power of video conferencing to reach outpatient patients in the late 90s and concluded that patients and providers are likely to build a partnership, which he said is the basis for effective treatment and medication management.

But before the epidemic, about 64 percent of psychiatrists had never used telehealth, according to the Psychiatric Association. Amid widespread skepticism, providers then need to make a "10-year start in 10 days," said Shor, who consulted with Dempsey and other providers.

Dempsey and his colleagues are facing a learning challenge. She said she recently had a video treatment session with a mother who "seemed to be very outgoing" before disappearing from the screen with her baby crying.

She wondered if the patient's discharge was related to the pressure of being a new mother or "something related to it," such as addiction, she said. Do you think she would have understood a woman better if they had been in the same room? The patient called Dempsey's team that night and told them he had returned to drug use and was taken to the emergency room. Mental health care providers have directed her to a treatment program, Dempsey said.

"We spent a lot of time looking at what happened in that case and thinking about what we should do differently," Dempsey said.

Providers are now constantly asking for the name of the person they will call if he or she loses contact and is no longer able to reach the patient.