Telehealth in the time of COVID-19: What does mental and behavioral health care for kids look like?

From health concerns to the stress of changed schedules, strained finances and missing out on favorite activities, everyone is facing challenges associated with coronavirus (COVID-19).

Kids and teens who were already receiving care for mental or behavioral health issues may be particularly vulnerable to this increased anxiety – one of the many reasons it’s important they continue their care via telehealth during this time of social distancing.

Dr. Cheryl Al-Mateen, medical director of our Virginia Treatment Center for Children provides a peek into what this may look like.

What are the benefits of using telehealth for mental and behavioral health appointments, particularly during COVID-19?

It’s really helpful for us to maintain a consistent and uninterrupted relationship with our patients. We want to make sure our kids don’t miss out on their mental health care, especially during a time when they may be facing some unusual and extra challenges. It’s also fun because in some cases we get to meet siblings and pets on camera, which may even help us understand a little more about our patients and their daily lives.

Why is it important to continue mental health care during this time?

COVID-19 has disrupted everyone’s lives. It’s stressful when we can’t maintain normal routines – school, work, getting what we need at the grocery store, doing all the things we like to do. As humans, our thresholds for disruptions have decreased because nothing is the norm anymore. With these increased stressors, we want to check in on our patients and make sure we can continue helping them.

What are the challenges associated with telehealth appointments for mental and behavioral health?

Our biggest hurdles are related to technology. Equipment doesn’t always work and internet is not consistent from one geographic area or home to another. If technological challenges prevent us from using a video platform, we have to connect with patients by phone and we lose the face-to-face interaction that is so important with mental health care. While challenges with technology are sometimes inevitable, it’s still critical to keep appointments. We are flexible and can make it work!

It can also be challenging to get all of the necessary paperwork completed. Not everyone has access to the tools necessary to print and return documentation from home.

How is your team working to overcome these challenges?

It’s important for us to be flexible. We’re working with families to help them navigate their technology and download any applications they may need for appointments. We are also working on new electronic forms that will allow us to acquire all of the documentation needed for providing care.

Our providers have had to make some critical adjustments to our normal practices, particularly as it relates to managing emergency situations. When we’re seeing patients in the office, we can call on nurses and other professionals in the clinic for assistance as needed. Since we aren’t physically with our patients during telehealth appointments, we have a set of information and resources for our providers to have at our fingertips.

Are there certain types of appointments not available through telehealth?

The answer to this question varies from one mental health discipline to another. Most appointments can be done via telehealth if the video component is functioning properly. We cannot do a psychiatry intake assessment by phone only. So much important information is conveyed in a face-to-face interaction, so if we’ve don’t have an established relationship with a patient and we can’t see their body language and non-verbal communication we’re not able to conduct an accurate assessment. In some cases there is testing or hands-on types of therapy that cannot be done virtually, but the vast majority of our appointments can be successfully conducted via telehealth.

Do you have any tips for parents to help make sure their child gets the most out of a telehealth visit?

• Turn off the television so your child can focus on the conversation with their provider.
• A parent should stay in the home for the duration of the appointment to answer questions, help with technology issues, etc.
• Having at least one set of headphones is very helpful. This allows an element of privacy when the provider is trying to talk with you or your child one-on-one. If headphones aren’t available, perhaps you or your child could go into a different room when private discussions are needed.
  • Privacy is very important to teenagers, and having at least a portion of the appointment just for them is necessary for most teens. 
  • Privacy is often very important for parents who may want some adults-only conversation with the clinician to give a complete history.
• It can be helpful to have a book, coloring book or quiet toy to keep your child occupied while you speak with the provider.
• Dress as you would if you were going into the doctor’s office for an appointment.
• If you’re using a tablet or smartphone, place it on a stable surface to minimize movement, background noise and reception issues. This sets the stage for clear communication.
• Remind your child this is their time to talk with the doctor. It’s just like when they go to the doctor’s office.

Take a look at our telehealth resource page for more helpful information.

What can patients and parents expect during a mental health visit via telehealth?

Aside from ironing out any issues with technology, it will be very similar to an in-person appointment. Parents may be asked to participate in the beginning or end, but the majority of the appointment will be focused on the child.

What is needed for a mental health appointment via telehealth?

In addition to a tablet, phone or computer with a microphone and camera, it will be helpful for you to have the following information for your child:

• Temperature
• Pulse
• Blood pressure (if you have access to a blood pressure cuff at home)
• Weight (if this is something your provider has discussed with you in the past)

These details will be important as the provider assesses symptoms and makes decisions regarding new or updated prescriptions.

Are kids able to see their regular providers via telehealth?

Yes, patients typically see their regular providers except in emergency cases when the regular provider may not be available.

What if a family decides they would prefer to continue in-person visits? Is that an option right now?

We are dedicated to your child’s health and safety and will do everything we can to provide them with the care they need. We are offering both telehealth and in-person appointments. You can schedule an appointment by calling (804) 828-3137.

If you do come in for an appointment, please keep in mind that we have updated visitation guidelines. You and your child will be screened for symptoms of COVID-19 and asked to wear a mask.

What should a family do if a child is in crisis, or if they need care but do not have a scheduled appointment?

• If your child is already a patient, please call us to arrange a telehealth appointment. We always have a doctor on call, so if it’s outside normal business hours you can reach us by calling the page operator at (804) 828-0951.
• Our Cameron K. Gallagher Mental Health Resource Center is available to help families of patients and non-patients in identifying resources that can best meet your needs. To connect with a family navigator at the resource center, call (804) 828-9897.
• If you are not a current patient, your local Community Services Board is also available to provide guidance and assistance.
• If there are signs of a physical illness, or if the situation is urgent, call 911 or go to the emergency room.

Have questions about mental or behavioral health care for your child? Learn more about the providers and services available at Virginia Treatment Center for Children.