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COVID-19 and telepsychiatry: Early outpatient experiences and implications for
the future
#MMPMID32750604
Chen JA
; Chung WJ
; Young SK
; Tuttle MC
; Collins MB
; Darghouth SL
; Longley R
; Levy R
; Razafsha M
; Kerner JC
; Wozniak J
; Huffman JC
Gen Hosp Psychiatry
2020[Sep]; 66
(?): 89-95
PMID32750604
show ga
The COVID-19 pandemic has dramatically transformed the U.S. healthcare landscape.
Within psychiatry, a sudden relaxing of insurance and regulatory barriers during
the month of March 2020 enabled clinicians practicing in a wide range of settings
to quickly adopt virtual care in order to provide critical ongoing mental health
supports to both existing and new patients struggling with the pandemic's impact.
In this article, we briefly review the extensive literature supporting the
effectiveness of telepsychiatry relative to in-person mental health care, and
describe how payment and regulatory challenges were the primary barriers
preventing more widespread adoption of this treatment modality prior to COVID-19.
We then review key changes that were implemented at the federal, state,
professional, and insurance levels over a one-month period that helped usher in
an unprecedented transformation in psychiatric care delivery, from mostly
in-person to mostly virtual. Early quality improvement data regarding virtual
visit volumes and clinical insights from our outpatient psychiatry department
located within a large, urban, tertiary care academic medical center reflect both
the opportunities and challenges of virtual care for patients and providers.
Notable benefits have included robust clinical volumes despite social distancing
mandates, reduced logistical barrieres to care for many patients, and decreased
no-show rates. Finally, we provide clinical suggestions for optimizing
telepsychiatry based on our experience, make a call for advocacy to continue the
reduced insurance and regulatory restrictions affecting telepsychiatry even once
this public health crisis has passed, and pose research questions that can help
guide optimal utilization of telepsychiatry as mainstay or adjunct of outpatient
psychiatric treatment now and in the future.
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