The Ideal Setting to Provide Telepsychiatry Services to Jarrett

Please respond to the discussion post below. Thank you

Hello All,



1. The ideal setting to provide telepsychiatry services to Jarrett would be a setting where privacy and confidentiality can be protected, with adequate lighting for both the client and provider to clearly visualize each other, utilizing reliable and secure telehealth platform capabilities. A suitable workplace should include careful attention to include furniture arrangement, lighting, and device capabilities that do not interfere with the client’s ability to clearly see and hear the provider; and to be seen and heard by the provider when possible. Issues with view angles, distortions to the on-screen display, and transmission errors and delays can impede free communication between the provider and patient (Kommu et al., 2020). The provider should make sure to include a clock in the workspace to ensure the timely and efficient flow of the interview as well as any other items that aid in creating a comfortable and inviting environment for the client.







2. Many of the essential preparations to the work space for the provider are important for the client as well, and Jarrett should be encouraged to ensure the device utilized is operational and the lighting and space does not impede the exchange of communication. Jarrett should also be encouraged to prepare his workspace by taking a few moments beforehand to ensure his comfort: consider the appropriate temperature of the workspace, comfortable attire and furniture and include any items that might aid in making the experience less surreal; perhaps a box of tissues, a beverage, blanket, or a familiar item such as a photograph nearby.







3. According to APA (2018) local, state, and national laws regarding verbal or written consent should be adhered to for telemental services. Laws regulating age of consent for telemental health services vary from state to state; therefore the telemental health provider should be familiar with the age of consent requirements in the state in which their clients are receiving services as most state law considers care as occurring in the state in which the patient is physically located (Kramer & Luxton, 2016). In the event that written consent is required, electronic signatures may be allowed (in relevant jurisdiction) to obtain consent (APA, 2018), and would be the preferred option to obtain consent if the electronic platform allowed. Consent may also be recorded in a simple sentence via email, text message, or audio (Mondal et al., 2020).







4. Additional requirements applicable to adolescent telepsychiatry include the considerations to ensure the safety of the youth, the availability of supportive adults, the mental status of those adults, as well as the ability of the site to respond to any urgent or emergent situations (APA, 2018). The provider should be informed of the specific emergency procedures for any site (clinic, school, etc) where telepsychiatry treatment of adolescents takes place and if none exist, the provider should ensure there is a backup of secondary method for contact in emergencies (Kramer & Luxton, 2016).







5. To assess the social determinants of health that might impact Jarrett’s treatment plan I would consider developing a general assessment form for patients to complete prior to initial telepsychiatry services to identify what resources and obstacles are present to help inform the development and maintenance of the treatment plan.







6. A safety plan for Jarrett can be created by identifying local emergency resources and contact information, identifying the location of the nearest hospital emergency department capable of managing psychiatric emergencies, having the patient’s family or support contact information readily available, and collecting contact information for other local professional associations, such as city, county, state, or regional professional associations in case a local referral is needed to follow up with a local professional (Kramer & Luxton, 2016). It is also recommended to know the local requirements, procedures, and phone numbers for mandated reporting to Child and Protective Services (Kramer & Luxton, 2016). State requirements for mandated reporting may vary as to types of professionals who must report, what they are required to report, the procedures and timeframes for reporting as well as whom information should be reported to (Kramer & Luxton, 2016). Regardless emergency procedure logistics, it is good practice to discuss all technical, clinical, and emergency procedures with the client and family or support person at the initial encounter (Kramer & Luxton, 2016).



When assessing who should be involved in Jarrett’s safety plan it is preferable to include those with appropriate legal interest in safety planning, such as his mother and stepfather (case worker, court staff, or group home staff would be considered as well if applicable) (Kramer & Luxton, 2016). These care collaborators would help the provider to assess and maintain a safe physical environment (Kramer & Luxton, 2016) for Jarrett to receive home-based care.







Christine







References



American Psychiatric Association (2018). Best practices in videoconferencing-based telemental health. https://www(dot)psychiatry(dot)org/File%20Library/Psychiatrists/Practice/Telepsychiatry/APA-ATA-Best-Practices-in-Videoconferencing-Based-Telemental-Health.pdf



Kommu, J., Sharma, E., & Ramtekkar, U. (2020). Telepsychiatry for mental health service delivery to children and adolescents. Indian journal of psychological medicine, 42, 465-525. DOI: 10.1177/0253717620958380



Kramer, G., Luxton, D. (2016). Telemental health for children and adolescents: An overview of legal, regulatory, and risk management issues. Journal of child and adolescent psychopharmacology, 26 (3), 198-203. DOI:10.1089/cap.2015.0018



Mondal, H., Haldar, R., & Mondal, S. (2020). Informed consent for telemedicine. Journal of family medicine & primary care, 9, 5402-5403.