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Minding Mental Health During COVID-19

10 June 2020
Blog

eClinicalWorks

How telehealth is meeting diverse needs

Too often the psychological impact of crises are overlooked, discounted, or recognized only after the fact. However, the effects of the coronavirus pandemic on mental and behavioral health are impossible to ignore.

Between job loss, stay-at-home orders, and limits on travel and social activities, most everyone is feeling the impact, ranging from mild cabin fever to serious and life-threatening psychological disorders.

In response, many providers have adopted telehealth to continue meeting patients’ needs. And there is growing understanding that those needs aren’t limited to physical ailments.

Caring for the whole person

“I’ve always had the belief that in pediatrics we should be the caretakers for both the medical as well as the behavioral and psychiatric care of the kids,” said Dr. Prasanthi Reddy, owner of Rainbow Pediatric Center in Jacksonville, Florida. “What we’ve seen out of COVID is just a huge influx of kids who are just nervous or anxious.”

Rainbow had already been using healow TeleVisits™ for treatment of ADHD. In response to the pandemic, they undertook other changes, including designating one of their clinics exclusively for sick patients, thus reducing the spread of illness.

Rainbow has gone still further to address mental health needs.

“We’ve just recently hired a psychiatry nurse practitioner to do televisits with families, even with the parents, just to talk them through it,” Dr. Reddy said. “It’s been a huge success for us.”

Responsibilities of providers

An April 13 article in the New England Journal of Medicine discussed sources of stress and the responsibilities providers have.

“Health care providers can offer suggestions for stress management and coping (such as structuring activities and maintaining routines), link patients to social and mental health services, and counsel patients to seek professional mental health assistance when needed,” wrote coauthors Dr. Betty Pfefferbaum and Dr. Carol S. North.

How one university is coping

College students may need mental health services given disruptions to campus life this spring and the uncertainties of obtaining coverage from providers in their home towns.

“We do see a lot of people who have anxiety and depression, which has been exacerbated because of the stay-at-home orders, and the general atmosphere regarding COVID-19,” said Mary Lou Nierzwicki of Indiana University Health Center.

Nierzwicki said telehealth has become an essential part of their practice because of the pandemic, and they are able to reach out to students in several states where hometown providers may be closed.

Telehealth can enhance quality

Other providers are finding that in addition to clinical effectiveness and convenience, telehealth can even improve the quality of the patient encounter.

Los Angeles-based APLA Health has been able to continue to provide mental health counseling via telehealth. Many patients have been able to use time usually devoted to their commute to fit in a session. And Dr. Sean Boileau said many patients feel more at ease being at home and are better able to enter into a deep discussion.

Greg Gelburd, D.O., owner of Downtown Family Health Care in Charlottesville, Virginia, described how one longtime patient was more relaxed than ever before during a recent televisit.

“You know, it’s surprising that talking to a screen can be so intimate. I made much further progress on that visit than I ever thought was possible,” Dr. Gelburd said.