By Susan Herman
Telemental health (TMH) is the use of telecommunication technologies to provide behavioral health services such as assessment, education, treatment, counseling and consultation. It refers both to live, real-time interactions as well as data sharing via asynchronous communication.
Over the phone and video teleconferencing systems, clinicians can provide care for most, if not all, the same conditions they treat in the office. Having a distance care option can increase access and decrease costs for consumers. However, telemental health can present certain logistical and safety complications. According to David Luxton, Eve-Lynn Nelson, and Marlene Maheu in their new book A Practitioner’s Guide to Telemental Health, complications can arise in regard to:
- establishing informed consent
- adapting intake and assessment protocols for the long-distance environment
- involving emergency or support services, if necessary, at the client’s location
- handling emotionally charged conversations when the client can easily power off their device, or when there might be another person in the room out of the clinician’s view
Asynchronous communication in TMH can include messaging technologies such as text or email—say, to ask follow-up questions or to check in on how well a patient is following a prescribed routine.
Software, apps, and peripheral devices for self-care and remote monitoring are also proliferating in the marketplace. These tools are broadly referred to as eHealth, or mHealth when deployed via mobile devices such as cell phones or wearables. They can be useful adjuncts to care, but cannot be used to diagnose mental health problems.
Some eHealth technologies provide alerts to prompt care providers to check in, similar to blood glucose monitoring systems for diabetics. According to the National Institutes of Mental Health (2016), “Such apps might use the device’s built-in sensors to collect information on a user’s typical behavior patterns. If the app detects a change in behavior, it may provide a signal that help is needed before a crisis occurs.”
Apps and wearable devices may include various coaching functions, self-monitoring, journaling, and/or stimuli (music, imagery) for help with:
- Anxiety and stress management
- Breathing and heart rate
- Challenging thoughts
- Recording moods
- Activity, sleep, food intake
- Meditation and mindfulness
Though it can be difficult to keep pace with innovation, providers and consumers alike should evaluate all telemental health tools carefully to make sure their data stays secure, and that actually using the technology doesn’t introduce more complications.
For a complete list of practice and ethical standards and guidelines in telehealth, including information on provider reimbursement for TMH and legal/policy issues, click here.
Luxton, D. D., Nelson, E., & Maheu, M. M. (2016). A Practitioner’s Guide to Telemental Health: How to Conduct Legal, Ethical, and Evidence-Based Telepractice. Washington, DC: American Psychological Association.
National Institutes of Mental Health (2016). Technology and the Future of Mental Health Treatment. Retrieved September 30, 2016 from https://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-health-treatment/index.shtml