5 Common Questions about Telepsychiatry in the ED

Access to prompt, high-quality care is of the utmost importance for psychiatric patients seeking treatment in the emergency department (ED). However, with a nationwide psychiatrist shortage, patients are left waiting for care in EDs across the country. Fortunately, telepsychiatry can help.

Telepsychiatry is a seamless solution that helps health systems provide timely care to psychiatric patients while increasing throughput for EDs. Read on to learn the five common questions healthcare organizations consider when investing in this solution.

How does the telepsychiatry process work in the ED?

Initiating a telepsychiatry consult is similar to calling any other consult in the ED. Here’s how it works:

Step one: A clinician evaluates the patient and determines whether or not they need a psychiatric consultation.

Step two: If they do, the clinician enters the essential information into a paging system, and an assistant in the ED takes a telehealth cart into the patient’s room.

Step three: From this point, the consult is nearly identical to a standard face-to-face consult. After the evaluation, the telepsychiatrist promptly calls a designated individual (such as a social worker) to discuss the basics of the patient’s presentation.

Step four: Next, the telepsychiatrist connects to the telehealth cart and speaks with the patient in real-time. The psychiatrist develops a treatment plan that typically includes a disposition and communicates this plan with the attending ED doctor.

Step five: Finally, the psychiatrist writes a note directly into an organization’s EMR, and the consultation is complete.

With five simple steps, telepsychiatry can facilitate a seamless process for providers, patients, and the organization at large.

Can telepsychiatry integrate within any health system?

High-quality telepsychiatry solutions can be seamlessly implemented into an organization’s existing equipment, including their EMR, prescribing system, and protocols for managing operations. At Iris Telehealth, we’ve found this is a crucial step to help minimize disruption. We act as a technology-agnostic addition to an organization’s team by becoming familiar with and integrating into their existing systems and workflows, and we ensure all staff are trained on best practices for using technology and are comfortable with it.

What type of equipment do health systems need for telepsychiatry?

The equipment required for telepsychiatry is relatively simple. The nature of psychiatry (which requires a person to person connection, but no mandatory physical assessment) makes it a well-suited field for telehealth as there’s not much equipment needed beyond a computer. If an organization already has existing equipment – ranging anywhere from telehealth carts to laptops and tablets available for use – chances are a telepsychiatry solution like Iris can implement with your current systems without any additional work and without your care team having to learn how to use new tools.

How long do we have to wait for the doctor?

In most cases, the wait is less than 30-minutes from the initiation of a consultation to the psychiatrist being at the patient’s bedside. Timing is essential in all areas of medicine, but it is critical within emergency medicine. For high-quality patient care, things must run efficiently to allow the timely delivery of services to your patients.

A good telepsychiatry partner should have systems in place to initiate a telepsychiatry consultation as quickly as possible. With an active and dynamic call pool of dedicated psychiatrists or other appropriate behavioral health providers (including LCSWs and PMHNPs), organizations can ensure a system that consistently puts a provider at the patient’s bedside in under 30-minutes.

What makes for a successful ED telepsychiatry program?

Cultural fit can make a significant difference in the success of your telepsychiatry program. That’s why it’s essential to partner with a telepsychiatry vendor who aligns with your vision and values. This compatibility is vital at every level, from the leadership team to clinicians. In fact, at Iris, we’ve discovered that provider match is essential to the success of a telepsychiatry program. Our process connects healthcare organizations with providers, thoughtfully, based on experience and need. This process allows us to ensure an organization’s population get’s the specialty care they need, and providers can work within their specializations – allowing everyone to get the most value.

Telepsychiatry groups are only as good as their providers. We work with the best psychiatrists, PMHNPs, and LCSWs in the field who learn the needs and goals of an organization’s ED. Over time, we’ve found that our providers can build authentic relationships with an organization’s staff and truly become integrated members of their treatment team.

Get started with telepsychiatry today

At Iris, we ensure your ED is set up for success and help facilitate an implementation process that’s smooth and straightforward. Once complete, your patients will have 24/7 access to a behavioral health provider and spend less time in the ED waiting for care. Telepsychiatry is a powerful platform that delivers quick access to the high-quality care patients need when they need it – whether at home, in an outpatient clinic, or a hospital.

If you would like to learn more about how you can optimize your behavioral health strategy in the ED, contact us today.

Addressing Mental Health Stigma in Rural Communities

Mental health stigma is a serious problem that can cause people to opt-out of treatment for their behavioral health conditions. In fact, a study by the Cohen Veterans Network found that nearly one-third of Americans have worried about others judging them for seeking mental health services. While one-fifth of individuals say they’ve lied to avoid telling people they were seeking mental health care.

Stigma can prove even more challenging for those living in rural communities with limited access to mental health resources. This population deals with unique barriers regarding anonymity in their communities, health literacy, pervasive provider shortages, transportation challenges, and more.

However, despite these barriers, telepsychiatry provides an opportunity for rural communities to receive the same level of treatment as metropolitan areas, helping them overcome stigma and get the care they need.

Keep reading to learn more about rural health stigma, how to address stigma in these communities, and successful community approaches.

How mental health stigma manifests in rural America

Stigma can take shape in many different ways. Whether it’s fear of public stigma or self-inflicted judgment, getting care in rural America isn’t easy. Let’s look at three unique barriers that this population may encounter when seeking care.

  • Lack of anonymity: Small towns don’t have the same level of privacy that cities provide. For example, someone is more likely to blend in when walking into a mental health clinic in a metropolitan area. However, it’s more likely that someone could be seen by a neighbor when walking in to get treatment in a small town, or they may even know the person checking them in for their appointment. This lack of anonymity can compromise a person’s feeling of safety and keep them from seeking care.
  • Family concerns: Another level of concern associated with stigma is family. People in rural communities may not want their family history or things that have happened in their families to be disclosed to anyone else. There’s a common colloquialism in some rural communities about not “airing your dirty laundry in public.” This mentality can keep someone from opening up to a mental health professional and receiving the care they need.
  • Religious barriers: Seeking care for mental health can be viewed as a spiritual weakness or a moral failing in many communities. In fact, a study by the Mental Health & Prevention journal uncovered several common themes related to stigma among rural, low-income healthcare consumers. Some of the top themes were, “faking and pretending,” “get over it,” and “God is all you need.” Additionally, some individuals may view taking psychiatric medications as oppositional to their religion.

While this population may be up against negative sentiments in their communities, there’s also potential to change the dialogue around mental health. And understanding what this community encounters is essential to determining the best way to help them get care and break the stigma.

Three solutions to help break stigma around mental health treatment

Tackling stigma in these communities can happen in several different ways, from education and telepsychiatry to sharing experiences and social media. Let’s take a closer look at these three unique approaches.

  1. Education: Good education is an essential component to breaking stigma. For example, educating people that the brain is an organ, just like the lungs or the heart, can help them better understand mental health. This education can happen within families, schools, workplaces, and religious organizations. Additionally, healthcare organizations that partner with telepsychiatry vendors like Iris Telehealth can also take an active approach to education that reduces stigma.In their StigmaFree campaign, the National Alliance of Mental Illness (NAMI) encourages people to use respectful language that doesn’t define someone by their illness, challenge misconceptions, and avoid labels. For example, instead of saying, “they’re bipolar,” try saying, “they’re living with bipolar disorder.”
  2. Increasing access: Access is a significant barrier for people living in rural areas. However, telepsychiatry serves as a creative avenue for support in these communities. This virtual approach allows people to connect to a high-quality, specialty mental health provider from the privacy of their home. Telepsychiatry can enable this population to get help and maintain their anonymity at a community level.The American Psychiatric Association (APA) calls telepsychiatry’s reach into rural and remote areas one of the best successes of telemedicine. The APA also cites that satisfaction has been superior for patients, families, and providers.
  3. Spreading awareness: According to the APA, about three in four young teens experiencing depression look online to find personal stories from others who have previously suffered from the condition. This data underscores the importance of spreading awareness through sharing stories.Social media can be a powerful platform for those in rural communities. Social media can connect people with support from others who might be dealing with similar conditions. This connection can help people feel less alone, and when people speak up about their mental health, it can be an excellent avenue for reducing stigma.

Taking these steps can help create powerful change for those experiencing the effects of stigma in their daily lives.

Successful approaches to combating stigma in the community

Creating opportunities for behavioral health care in the community is a game-changer for this population.

  • Effective programming: Programs that assist with opioid use disorder have been effective in helping reduce stigma. By providing safe injection sites, and implementing harm reduction or replacement therapy, more lives are saved. While these programs are often misunderstood, the more people are educated on the serious outcomes of utilizing substances and how intervention can save lives, the more they understand.
  • Organizational solutions: Turning to emergency departments often feels like the best option for individuals living without adequate mental health resources. However, emergency care is costly. That said, hospitals that create opportunities for 24/7 behavioral care access can help better serve their communities with high-quality, on-demand services. Along with this organizational approach, communities can receive grants for crisis centers and other solutions that can help address mental health concerns outside of the emergency room. Instead of waiting for something to become a problem, putting preventive measures in place can be a more effective strategy.
  • Telepsychiatry: Finding providers can be a daunting task for organizations in rural communities. For Aroostook Mental Health Services, Inc. (AMHC) in rural northern Maine, recruiting and retaining high-quality behavioral healthcare providers was challenging. Specifically, AMHC needed psychiatrists specializing in children and adolescents and a psychiatrist for consultation help. That’s where Iris Telehealth came in to connect AMHC with high-quality, trained providers. Not only do their patients get the specialty care they need, but their physicians get the consultative support they need before prescribing or diagnosing certain conditions.

Where Iris Telehealth fits in

At Iris, we partner with communities in need of mental health resources. By providing rural populations access to specialty behavioral health providers from around the country, we can help support their needs. Contact us today if you would like to learn more about how telepsychiatry can support your community.

How Telepsychiatry Helps Impact Social Determinants of Health

Social determinants of health (SDOH) are defined by the conditions of an environment where people are born, live, and work. Depending on an individual’s circumstances, these conditions can create and exacerbate mental illness and make it difficult to access mental health care.

Despite these challenges, healthcare organizations have the power to make meaningful change by bridging the gap between underserved populations and high-quality mental health care. By investing in solutions like telepsychiatry, healthcare organizations can positively impact their communities’ mental health.

Read on to learn more about why social determinants of health and mental health matter to healthcare organizations, how healthcare organizations can address them, and additional resources to help reach those who need care the most in your community.

Why SDOHs matter to healthcare organizations

Healthcare organizations are catching on to the importance of addressing social determinants of mental health. In a survey of 300 hospitals and health systems, the Deloitte Center for Health Solutions found that 80% of hospital respondents said their leadership team is committed to establishing and addressing social needs in clinical care. Providers see the value, too. The Commonwealth Fund reports that 80% of physicians consider addressing a patients’ social needs as critical as addressing their medical needs.

And, the potential financial impact of not addressing SDOH is substantial. An article by Modern Healthcare highlights a Chicago-based health system that discovered 26% of its medical inpatients had a co-occurring behavioral health issue that cost approximately $26 million annually in excess healthcare costs and increased the average length of stay by 1.07 days.

Taking an integrated approach that encompasses mental and physical healthcare needs is essential to helping underserved patients and maintaining organizational costs.

Identifying who needs help in your community

For those experiencing SDOH, lack of access to routine mental and physical healthcare can impact their quality of life. And the effects are widespread. In fact, in a study by Anthem, 60% of Americans believe their community faces at least some health issues related to SDOH. 23% say access to good doctors and hospitals is a major problem for those in rural parts of the country.

Anthem also found that Americans of color are disproportionately affected by the consequences of SDOH, citing mental health, safe communities, and access to affordable and nutritional foods were components significantly impacting their health.

Along with these challenges, there are specific factors that stand between individuals experiencing SDOH and a more sustainable quality of life:

Whether your organization aims to help a specific population or contribute to solving a unique issue in your community, you should consider a few things before getting started.

How healthcare organizations can address SDOH

With a pandemic and a growing provider shortage at play, helping patients get appropriate and affordable mental health care has never been more important or challenging.

So what can hospitals and health systems do to help relieve the burden on overworked providers while facilitating high-quality care for their patients? It starts by ensuring your teams are set up to address these challenges.

Consider the following:

  • What type of geographic access does your population have?
  • What resources are available?
  • Are people motivated to utilize these resources?
  • Do they have a support system?

When addressing SDOH in the community, chances are you might face some challenges related to stigma, transportation, and socioeconomic status. While these might be difficult to address, there are four solutions to these challenges that can help your organization realize optimal outcomes:

  • Stigma: For those facing stigma in their communities, providing a telepsychiatry option can be helpful. That way, they can receive effective treatment from the comfort of their homes, or through their primary care provider’s office, without the worry of being exposed for seeking help.
  • Culturally competent care: Using telepsychiatry can help organizations access providers who speak a specific language or have experience with a particular culture. This connection is highly beneficial to individuals who may not have someone locally who speaks the same language or can understand the unique aspects of their culture.
  • Technology and digital literacy: By partnering with organizations that seamlessly integrate into your organization, patients in your community can access providers from across the country at their local clinic, regardless of what personal access they may have at home.
  • Transportation: If patients have trouble getting to their appointment because of transportation challenges, telehealth can help them get the care they need from home. Along with a virtual approach, your organization can consider offering free transportation, or partnering with a ride-share company, to help individuals make it to their appointment.

Additional Resources

If you’re looking for additional resources to reach your community, check out some of the options below:

American Psychiatric Association: The American Psychiatric Association has collected a series of factsheets that provide an inside look into current mental health disparities experienced by diverse populations. This is a meaningful resource that your organization can reference when determining how and who to help.

Iris Telehealth: Iris Telehealth provides high-quality behavioral health services for patients across the country. Wherever the need, Iris meets people where they are, helping to break stigmas and defy geographic and economic barriers.

AHA Resources: The AHA provides recommendations on improving health equity or check out what they suggest your organization can do to ensure access to care. Whatever the need, AHA has a bounty of resources for reference.

RHIhub SDOH in Rural Communities Toolkit: RHIhub has compiled a toolkit of resources, including content around care coordination, community health workers, health promotion, telehealth, rural transportation, and more.

Where Iris Telehealth fits in

Iris Telehealth works with healthcare organizations across the country to bring high-quality, specialty psychiatry services to people who need them most. If you’re a healthcare organization looking to increase access in your community, Iris Telehealth can work with you to seamlessly integrate behavioral health services. Contact us today.