Therapists tap telehealth to connect with patients

Updated: 10:57 a.m.

Until last week, Jen Atherton, a mental health counselor, had rarely ever seen clients outside of her office — Not anymore. Like a lot of us, Atherton is working from home now and she’s seeing her patients via video. She said for her office, the switch to telehealth “was pretty much an overnight thing.”

So far, the biggest challenges have been technological: Some of it is bandwidth, which can get crowded with so many people on the internet and on Wi-Fi networks. Atherton said she’s also encountered problems with clients’ cellphones or when they’re sitting in noisy places.

She said she’s trying to adjust the best she can.

“There have been times where I’ve done half a session where I’ve been able to see somebody and then we just can’t connect and we keep trying to reconnect it, troubleshooting and it’s just not happening, so we just finish on the phone if we have to,” she said.

It’s not surprising that the new coronavirus dominates at least the start of every conversation she has, but she said she’s also found an unexpected upside to telehealth, when it does work. She gets to see her clients in their natural habitats.

“That’s a thing that I have enjoyed so far,” she said, “being able to see their puppies or how their living room looks, that’s a window you don’t usually get when you’re seeing them in your office.”

Community mental health workers, on the other hand, are used to seeing people in their homes, at school, even in homeless shelters, and that’s important for them to understand what’s really going on with the families they serve.

“I can walk into a home and I can tell you more about a family in five minutes by being with them, seeing them, seeing their home than you can in five months of having them come into an office where maybe they dress up a little bit and comb their hair,” said George Dubie, CEO of Greater Minnesota Family Services, whose clinicians work with at-risk children all over the state.

He’s worried that with new rules about social distancing, clients who can’t access care through telehealth won’t get any mental health care at all. He estimates that 20 to 25 percent — maybe more — of the families they serve don’t have smartphones, computers or the kind of internet access that would let them access telehealth services. For now, he said his providers are getting around that by informally checking in on clients on the phone.

There are things complicating all of this, too. Federal HIPAA privacy rules are one challenge. Until a few weeks ago when the coronavirus hit in earnest, technology for telehealth had to meet certain conditions to be HIPAA-compliant. The government has started changing the rules around HIPAA generally, but providers are still trying to understand exactly what that will look like.

Then there are the insurance companies: Just like everything else, insurance companies have to approve telehealth sessions, and not all insurance plans do.

Colleges and universities were among the first places to start going virtual. At the University of St. Thomas, student health services stayed open after classes went online. But starting Monday, all mental health services at St. Thomas University will go remote.

Madonna McDermott, who runs the school’s Wellness Center, said her office has spent the time in between making sure all the pieces were in place.

“Does everybody have a camera on their computer and if not, do we have enough of other laptops, etc., to be able to do this,” she said. “Or do we add a camera?”

She expects more students will be looking for mental health care as the situation continues to unfold.

This reporting is part of Call to Mind, our MPR initiative to foster new conversations about mental health.