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Pandemic has caused pain for mental health patients, but also provided more care through virtual therapy

The Standard Times
Jun 17, 2020

Jun. 17--The pandemic has been a double-edged sword for many mental health patients, simultaneously causing them more pain and also providing an additional resource for care, a medical expert said.

Their disorders have become more acute during this period, but the pandemic has also given rise to tele-psychiatry, which provides them with more care in a setting that is comfortable to them, said Leonardo Batista, chief of psychiatry at Morton Hospital, Taunton.

The requirements to work from home and maintain social distance has created special and unique problems for many patients, said Batista, who left a faculty position at Brown University, Providence, Rhode Island, about a year ago to take the position as chief of psychiatry at the Taunton hospital.

They feel isolated, alone and often depressed, he said. "It (the pandemic) created a new challenge to work with patients," he said.

In short, the pandemic has added another layer to their existing conditions, he said. Their increased personal struggles are reflected in increased patient-doctor interactions through phone calls, texts and emails.

However, tele-psychiatry -- another form of tele-medicine -- has created better access to care and may have helped pave the way to a brighter tomorrow for many, said the 41-year-old psychiatry chief, who is passionate about better access to mental health care and ending the stigma associated with mental illness. Tele-psych sessions are conducted either over a video chat or over the phone.

Tele-psychiatry allows providers to meet patients where they are and tailor a treatment plan to fit their needs, he said. Patients are more comfortable with virtual therapy sessions because many struggle with the stigma surrounding mental health and are reluctant to go to a therapist's office.

"They are now able to be seen in the comfort of their homes. This has provided them with a feeling of safety which has been positive to their treatment," he said. "They are more willing to relax in the comfort of their own homes."

Online psychiatric sessions has also eliminated a major issue to their participation -- transportation, which often physically prevents them from getting the care they need, he said.

Virtual therapy has been such a success that now many patients are "looking forward" to the next step in their treatments -- in-person visits in their therapists' offices, he said.

Oftentimes, patients are "skeptical" about speaking with psychiatrists about their issues in their offices due to the stigma, but after a video chat or a phone conversation they are "more open" to the idea, he said.

As a result of virtual psychiatry, patient attendance rates are "improving" and there are less "no-shows," he said.

The benefits of tele-psychiatry has vastly exceeded anyone's imagination when psychiatry, like so much of medicine, was forced to switch gears from office visits to virtual visits, he said. Initially, there was the thought that the reduced in-person contact would be "a detriment" to psychiatric medicine, but it has proven "very beneficial," especially for those patients who need a safe environment.

Virtual psychiatry has allowed therapists to be "eyewitnesses to what is happening at home" and intervene and help patients develop "coping skills," he said. It has led to less emergency room visits and less hospital admissions, he said.

Derek Foulds, director of in-house therapy and assistant clinical director of the Behavorial Health Center of the Family Service Association of Fall River, said virtual sessions have worked so well that maybe psychiatric medicine might evolve into "a hybrid" -- or a combination of virtual therapy sessions and in-person visits -- in the future.

"We see that (telemed) is another option to help our profession. It adds another tool to our tool box," he said.

Virtual therapy was "thrusted upon us," and therapists and patients were required to adjust on the fly once restrictions were imposed, he said. The adjustment went well and continues to go well, he said.

"The discussion (over the computer or over the phone) happens just as it would in-person," he said.

Using video chat devices like Zoom and FaceTime, therapists can see patients, while also noticing their body language, which may bely what they are telling their therapists.

"The patient may say he is 'fine,' but he is wrenching his hands as he speaks," possibly indicating he is not doing as well as he says, Foulds said.

In addition to transportation issues, patients have "physical issues" like "not feeling well," which interfere with their care, and now can be worked around with virtual therapy, he said.

Follow Curt Brown on Twitter @CurtBrown_SCT

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