In the spring of 2020, COVID-19 brought rising levels of stress, anxiety and depression. But stay-at-home orders and a national emergency prompted many psychiatric and psychotherapy offices to shut down and cancel in-person appointments.
But the idea of seeing patients via video had been around since long before then. In 1973, a team of behavioral scientists studied the two-way interactive television system Massachusetts General Hospital started using in 1969. The hospital provided mental health evaluations at an off-site medical station at Logan International Airport in Boston and a Veterans Affairs hospital outside the city.
Enter COVID-19 As the pandemic forced lockdowns around the country, health insurance companies quickly loosened restrictions and allowed doctors to provide care remotely, regardless of geographical location. A variety of software programs, such as FaceTime, Skype and Zoom, received approval for this purpose under relaxed federal restrictions.
Built-in benefitsPsychiatry calls for physical examination much less often than most other medical specialties, making it ideal for telemedicine. The pandemic also had a role in allaying previous concerns about patients’ being unable or unwilling to use video technology. As remote videoconferencing became a necessary and regular part of communication with workplaces, family members and friends, patients essentially trained themselves to use it in their mental health care.
This has turned out to be especially useful for people with complicated work schedules, like medical personnel and first responders who are facing struggles of their own during the pandemic. Another issue is that for some patients, the easier access of telehealth can make their visits feel like a less serious routine task rather than treatment. My colleagues and I have had to warn patients not to connect with us while driving or shopping or while in the middle of a conversation with others. Some also had to be reminded to dress appropriately for their online appointments with us; a patient showed up onscreen in a bathrobe.