We live in a time when health care is being transformed by technology and mobile applications. Few mental health services, however, have been delivered via technology, despite offering an easy and convenient way to reach patients.
Live video telehealth services are a critical component of the COVID-19 response. Offered by physicians, other clinicians and health-care organizations, telehealth provides a useful method for starting and continuing essential mental health treatment without risk of spreading infection.
This is especially important given the anxiety many are feeling due to the uncertainty of COVID-19 and the sense of loneliness that can result from stay-at-home and shelter-in-place orders that public health experts have encouraged to save lives.
Most people with serious mental illnesses own and use a mobile phone, according to a study that included researchers from UCLA. This is a good time for clinicians to start using mobile technology to provide interventions to our patients.
A major barrier to video telehealth has been the refusal by payors, including Medicare, to pay for most of these sessions. While some private insurers started to pay for these visits, others have continued to refuse coverage, or have created administrative barriers that limit coverage.
Recently, Medicare announced that beneficiaries can receive covered telehealth services even if they do not live in a rural community where providers are scarce. Clinicians can bill for dates of service, starting March 6. The extent to which private insurers will follow suit remains to be seen.
To ensure access to telehealth, some state governments have taken action with insurance companies that are subject to their regulations. The federal government has not yet taken similar action, and some insurance companies continue to restrict coverage for telehealth, despite the national emergency.
Furthermore, the federal Department of Health and Human Services’ Office for Civil Rights announced it will waive potential penalties for HIPAA violations against health-care providers that serve patients through widely available non-public communication applications like FaceTime and Skype.
Live video telehealth works with almost all patients with mental health issues. It is well accepted and effective. At UCLA, we have rapidly moved to delivering mental health services by telehealth. Telehealth can play a critical role in ensuring continuity of care for people with mental illness during the COVID-19 pandemic.
Alexander Young, MD, is the interim chair of the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA, the interim director of the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, and interim physician-in-chief of the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA.
