Will the Telepsychiatry Explosion Fueled by COVID-19 Persist After the Pandemic?

The loosening of telepsychiatry restrictions prompted by the COVID-19 pandemic has led to an explosion of telepsychiatry that is likely to persist when the crisis is over, emergency psychiatrist Avrim Fishkind, MD, said at the American Psychiatric Association (APA) Spring Highlights Meeting.

A slew of various government regulations has stifled the widespread growth of telepsychiatry in recent years, said Dr. Fishkind, who first became interested in the practice in early 2000s and helped redesign psychiatric emergency services in Texas using telepsychiatry in the mid 2000s.

With large swaths of the country ordered to stay at home in recent months, waivers have been issued for many of those regulations, including rules on physician location and state licensing, HIPAA violations, permitted videoconference platforms, documentation, and prescribing controlled substances, he said.

Examining the Mental Health Toll of Disasters

“One of the things that the COVID crisis has done is it has democratized telemedicine,” like podcasts did for radio, Dr. Fishkind said.  

“It was always something that was thought of that was done by a few specialists, was overly complex,” he said. “In a blink of an eye, every psychiatrist and every mental health professional now can see themselves, and many have been forced into, becoming telepsychiatrists. And I think this is one of the greatest things that has ever happened to our profession.”

Telepsychiatry dramatically increases access to populations that may have had trouble finding services, such as rural populations and even patients on cruise ships, Dr. Fishkind explained. It also allows clinicians to work in multiple locations and institutions across the country within the same day, and may be a more comfortable setting for some patients, such as those with personality disorders.

Dr. Fishkind believes, and hopes, that the expansion of telepsychiatry will not be something that is reversed once the COVID-19 crisis is resolved.

“I think the old feeling, that each state was responsible for protecting its citizens and had to have an individual medical licensure, those days are fading,”  he said. “I think once the genie is out of the bottle that many regulations will not go back fully to where they were previously. And I hope they don’t.”

—Terri Airov

Reference

“Expansion of Psychiatric Practice Through Telepsychiatry During the COVID-19 Era.” Presented at: the American Psychiatric Association Spring Highlights Meeting; April 26, 2020.