Op Ed – June 8, 2020 – by Roger Osmun
New Hampshire Union Leader
TELEHEALTH has become part of many people’s vocabulary in the past few months now that the COVID-19 pandemic is with us. While telehealth existed for many years previously, the need for physical distancing to prevent infection by the COVID-19 virus has brought the concept and the practice into the mainstream. The field of psychiatry and behavioral health has been on the forefront of telehealth for at least a decade given the relative ease of providing these services compared to many forms of physical health care interventions.
Telehealth entails the use of current computer technology to engage with an individual client or patient in a secure, real-time, audio-video communication. While applications such as FaceTime and Skype allow for real-time communication, these platforms have not offered the security to provide health care. This inherently requires providers, such as West Central Behavioral Health, to pay for both the hardware and the software subscriptions to maintain HIPAA-compliant secure connections.
Although COVID-19 has necessitated the use of telehealth in order to continue to provide necessary behavioral health services to our clients, it has also allowed us to develop powerful insight into its magnitude as a treatment tool. The generation of children, adolescents, and young adults born into a world of smart phones and handheld tablets are so accustomed to these forms of communication that they often find it easier to relate to their therapist while interacting online.
On the clinical side, there are differences between the use of audio-only and audio-video means for telehealth. While the use of phone-only services gives people ready access to their therapist or psychiatrist, it has drawbacks. The use of audio-video for telehealth is preferred because it allows for a much more naturalistic interaction between therapist and client. People who can see one another can discern body language and facial expressions that oftentimes tell all. Therapists can also see a client’s surroundings to better understand how they live—in some cases, gaining even more insights into the client’s world than if the therapy session took place in an office setting.
While I applaud all frontline health care workers for their valiant and courageous efforts during the COVID-19 crisis, I also want to recognize all of the dedicated behavioral health workers who have continued their front-line work while adjusting to the newly-implemented telehealth tool and methods. As good as telehealth may be, we still need to see plenty of people in person to treat them with medications/injections and clinically-necessarily community-based services.
I hope that even following the resolution of our current health care crisis, we can maintain the use of telehealth as a means of offering valuable treatment to our community members in need. As a behavioral health professional and administrator, I hope that professionals and policy makers alike continue to embrace telehealth as a valuable extension of traditional health care — not as a replacement but a complement. However, this effort requires that the recent relaxing of state and federal requirements that allow for telehealth treatment be continued in the post-COVID world.
If you have engaged with either a physical or behavioral health care worker through this means and found it beneficial, I encourage you to let your voice be heard. Telehealth was not a viable option when I started practicing psychology over 25 years ago, but I definitely want to see it remain a viable option for all my clinical staff and my professional behavioral health care colleagues throughout the state of New Hampshire.
We are now witnessing firsthand an explosion of mental health and substance use issues exacerbated by the current pandemic. It has become clear to many that behavioral health care treatment is an essential and integral part of the health care mainstream. Going forward, we will need as many tools as possible to treat the growing numbers who turn to us for help. Current technology in its many exciting forms will be key to our success.
Roger W. Osmun, Ph.D., is president and CEO of West Central Behavioral Health in Lebanon.