Telehealth in an Age of COVID-19
August 2020

Alisa Balestra, PhD

The impact of COVID-19 on domestic and foreign sectors has been lasting and far reaching. Through stay-at-home orders, school and business closures, and cancelled social and recreational events, how we live and conduct business under COVID-19 has required new and often virtual methods of engaging with others. Medical and behavioral health providers have not been immune to COVID-19 and its effects on access, service delivery, the provider-client relationship, and appropriate client follow-up.

The Centers for Disease Control and Prevention (CDC) released in June 2020 guidance for health care workers on telehealth and the way it can expand access to essential health services during COVID-19; unlike in-person services, telehealth uses digital information and other technologies to help patients both access services remotely and manage their care. For many people, telehealth removes barriers to care such as transportation and access (e.g., limited mobility, patients in rural areas, etc.); however, telehealth also creates limitations for some around privacy, comfort with the provider, and cultural attitudes towards virtual rather than in-person visits.

Responses to the use of telehealth for local behavioral health providers have been mixed: for some providers, telehealth increased engagement with clients previously limited by transportation issues, employment conflicts, and other scheduling challenges. For others, telehealth presented challenges to both providers and clients: the abrupt shift from in-person to virtual visits did not allow for adequate training in conducting telehealth, and without adequate training providers struggled to adapt in-person interventions for virtual environments. As a result, telehealth was met with hesitancy and distrust from some clients, and the provider-client relationship was compromised.

Both the CDC and the American Psychiatric Association (APA) are clear: telehealth offers advantages to patients and clients in the delivery and management of their care; however, providers should receive adequate training on how to conduct virtual care, should assess if the patient/client is best suited to telehealth, and should consider how best to adapt interventions for virtual environments. The APA’s toolkit offers guidance for best practices in delivering telehealth, including delivery to special populations (e.g., youth/adolescents, etc.). “It felt like engaging families for the first time,” one local provider said in delivering virtual services to transitional age youth. YouTube, Pinterest, and other forms of social media have kept families engaged, but for how long remains the question.