Addressing Mental Health Needs in a Pandemic via Telemedicine

Scaling up telePsychiatry during the pandemic finds best practices.

Telemedicine has allowed Chesapeake Regional to meet the needs of our mental health patients until they are transferred to a specialized mental health facility or released with a care plan.

The COVID-19 Effect

We've collaborated with SOC Telemed for on-demand access to board-certified psychiatrists since 2014. In partnership with our in-house physicians, these psychiatrists use remote technology to assess mental health patients in real-time in the Emergency Department, as well as provide consults to admitted patients on the medical floors.

Our telePsychiatry program changed drastically with the introduction of COVID-19 in March 2020. Suddenly all of our local inpatient psychiatric care facilities began declining patients who tested positive for COVID-19, despite being asymptomatic.

During the height of the pandemic, when our hospital dedicated three units to patients with COVID-19-related symptoms and complications, the psychiatric patients who arrived at our Emergency Department did not have a “medical” reason for being there, but they still needed care for their mental health conditions—and they had nowhere to go. For example, a patient arriving with suicidal ideation or schizophrenia who also tested positive for COVID-19 was refused at an inpatient care facility but could not be released to self-quarantine. This was a quandary many area hospitals faced.

As beds in the Emergency Department began to fill and the pandemic persisted, we knew we had to find a solution. We worked with hospital leadership to discuss our options and decided that telePsychiatry could help.

In collaboration with SOC Telemed, we began treating and stabilizing patients within our hospital and continue this patient-focused process today. Board-certified SOC psychiatrists are available day or night to review medical history, prescribe medications and provide routine follow-up to help manage each of our patient’s needs. I provide the therapeutic intervention to include daily psychotherapy sessions, symptom management education and family therapy. The medical team, including nurses and attending physicians, places the orders, administers the medication and monitors the patient’s health for COVID-19 per CDC guidelines. In partnership with the hospital’s Care Management team and our local Community Services Board, patient care is coordinated for referral and ongoing care to increase the likelihood of a positive clinical outcome. This multi-pronged approach has been very successful to date.

Better Patient Satisfaction

Our partnership with SOC Telemed has helped us serve our community when we were hit hardest with COVID-19 patient surges in the months of July, September, November and December. During these four months, we averaged an 80% increase in emergency psychiatric consults. The SOC psychiatrists carefully reviewed each patient's mental health history, discussed the treatment options at length with our staff and the patients, quickly onboarded medications and made adjustments, as necessary.

With therapy sessions, we have been able to continue to provide an environment that is customized for the specific needs of each patient. This has allowed Chesapeake Regional to provide excellent, specialized care even in the midst of the pandemic. It has also provided a blueprint for continued patient care opportunities.

Prepared for What’s Next

As of spring 2021, the local inpatient psychiatric care facilities surrounding Chesapeake Regional have yet to re-open their doors to psychiatric patients who have tested positive for COVID-19. However, we are still prepared to provide excellent, tailored care whenever it is needed, thanks to our around-the-clock psychiatry access. The flexibility and effectiveness of telePsychiatry truly allows us to address the mental health needs in the community during the pandemic and beyond.