June 22, 2018
by Zory A. Wentt, LCSW-R
Regional Director of Out-Patient Clinics, Astor
“The help has finally come to me,” said a parent of a child served by Astor after experiencing Astor’s tele-psychiatry service. “I could not believe that this technology was available and even more so, to me and my daughter.”
What exactly is tele-psychiatry and why is this mom so excited?
If one were to Google this concept of tele-psychiatry, the result would be things like “telehealth” and “telemedicine.”
One technical definition found through such a search was: “…tele-psychiatry is the application of telemedicine to the specialty field of psychiatry…” In modern, everyday terms, tele-psychiatry is like FaceTiming with your medical provider.
Nothing beats the intimacy of the face-to-face contact we experience when speaking with our medical providers. However, tele-psychiatry, where people see and talk with their medical provider by way of a video program, is a very close second.
Astor was the first behavioral health organization in the Bronx to begin using this service in its free-standing clinics in the Bronx, as well as certain schools in the borough in the fall of 2016 and will be expanding to its approved clinics in the Hudson Valley.
In fact, Astor was one of the first agencies within New York City’s five boroughs to receive approval to use tele-psychiatry for its clients from the NYS Office of Mental Health. This is what Astor does. The organization stays ahead of the curve by keeping a keen eye on what’s next and always thinking about how it can better serve and reach the children and families most in need.
It is important to note that tele-psychiatry communications are secure through the Health Insurance Portability and Accountability Act (HIPAA), which provides security and privacy standards for electronic medical information exchange, including tele-psychiatry. In addition, there are a large number of HIPAA-compliant technologies available for tele-psychiatry, all of which are embedded into Astor’s system. Many thanks to Astor’s information technology department!
One of the drivers behind tele-psychiatry growth in the United States has been a national shortage of psychiatrists, particularly in specialty areas such as child and adolescent psychiatry. Moreover, psychiatric services are expensive and at a premium in terms of availability. In addition, the population that Astor serves (children and adolescents in underserved communities), often miss much-needed psychiatric appointments because of problems with transportation and other issues, making tele-psychiatry’s an effective alternative to the continuation of care.
In addition, tele-psychiatry allows fewer doctors to serve more patients by improving the utilization of the psychiatrists’ time. It can also make it easier for psychiatrists to treat patients in under-served areas by eliminating the need for either party to travel for an appointment, thereby bringing the services to the families
that need them.
For example, one of Astor’s single mothers of four often times misses appointments because of the high cost of transporting all five family members to the clinic. Conversely, the cost of childcare was prohibitive, so this parent claims that tele-psychiatry at school “changed her world.” She said that she felt an “oasis” has opened up in her neighborhood and she is now able to access her daughter’s medical needs without the stress of having to figure out how
to get to the help.
So, is tele-psychiatry for every child and family? No. Access involves an initial face-to-face visit with a psychiatrist, followed by an assessment as to whether tele-psychiatry is best for the child.
For instance, for difficult cases tele-psychiatry typically is not recommended. Once a child has the “green light” to participate in the service, the medical staff consults with the school staff on the child’s progress and links to the program’s satellite for emergency situations. Medication management can be done from the provider’s office in the clinic. It also links our satellites and the clinic by allowing staff to obtain remote consultation. This has the potential to help reduce costs by allowing remote supervision.
Astor’s decades of working with children in the Bronx have shown that better results are attained when services are brought to families as opposed to having them provided via outpatient clinics, hence, “let’s face-time with our docs!”
These are very exciting times in Astor’s history. I feel fortunate to have taken part in such innovation in the world of not-for-profit organizations.
For more information about Astor’s Tele-Psychiatry Service and our Outpatient Clinics in the Bronx and Hudson Valley, please contact Michele Kelly, Psy.D.
Highbridge OPC 718-732-7080
Tilden OPC 718-231-3400
Learn more about Astor’s
Community-Based Educational and Mental Health Programs for Children and Adolescents