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When Is Telehealth Not Enough for Mental Health?

When Is Telehealth Not Enough for Mental Health?

When Is Telehealth Not Enough for Mental Health?
This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255). If you need help, call now.
The Lindsay Clancy case raises questions about telehealth for mental health.
Many Americans with serious mental illness get treatment via telehealth, according to SAMHSA.
Clancy had 14 virtual visits with her psychiatrist over five months. The final visit was the day before the killings. They never met in person. Clancy's case is complex. Her treatment is being questioned. The use of telehealth is being examined. The case has sparked debate. It has also raised concerns.
Lindsay Clancy's trial stopped due to her sudden breakdown.
Clancy's lawyer questioned her psychiatrist about relying on virtual appointments.
Many American adults with serious mental illness get telehealth treatment.
Clancy's lawyer asked if she should have seen her psychiatrist in person.
The psychiatrist said talking to Clancy over video didn't seem like an issue.
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Jonathan Alpert says virtual care can work, but sometimes it's not enough.
Alpert says he's less comfortable relying on screens for sicker patients.
If someone is becoming suicidal or unstable, they may need in-person care, Alpert says.
The priority is getting an accurate picture and keeping the patient safe.
Telehealth is important for mental healthcare and offers many benefits.
Alpert can see more patients virtually than in his office.
Drinking every day can be a sign of alcoholism, experts say.
Virtual therapy eliminates the commute, which can be helpful for busy people.
But virtual therapy has limitations for severe psychiatric disorders, Alpert says.
Lindsay Clancy sits with her lawyer during her trial.
Some things, like hygiene or agitation, aren't obvious on video, Alpert notes.
A patient can look fine on video but be struggling outside of the appointment.
If a patient gets worse despite frequent appointments, that's a warning sign.
The treatment plan may need to change, such as seeing the person in person, Alpert says.
More appointments aren't always more treatment, Alpert says.
The treatment plan needs to change if someone is becoming more suicidal or unstable.
Telehealth has helped many people get care who otherwise might not have.
In cases of suicide or violence concerns, therapists should ask direct questions.
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If someone has a plan to harm themselves, it's a serious concern, Alpert says.
If you or someone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline.
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Therapists should know the patient's location during virtual appointments, Alpert advises.
Sometimes, therapists need information from family or others in the patient's life.
A good clinician can identify serious risk over video, but may also miss it in person.
Alpert emphasizes the difference between postpartum depression and postpartum psychosis.
Postpartum psychosis may require inpatient treatment, Alpert says.
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Telehealth itself is not the problem, Alpert says.
The issue is whether the clinician is doing a thorough assessment, Alpert says.
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A good clinician can identify risk over video, but may also miss it in person, Alpert notes.
The sicker someone is, the less comfortable Alpert is with just virtual care.
Melissa Rudy is a senior health editor at Fox News Digital. You can send story tips to her.