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Telepsychiatry for Psychiatric Crisis Centers
 Facing many of the same challenges as a hospital’s general emergency department psychiatric crisis centers are often presented with an even more daunting task. Often given a charge and an expectation to provide timely psychiatric specialty services on demand over a 24/7/365 coverage period, psychiatric crisis centers are often put in the very difficult position of having to do more with less.Amid a negative national trend of budget cuts, shortages of psychiatrists, and an increasing prevalence of behavioral health issues, psychiatric crisis centers are being expected to provide 24/7 access to psychiatrists to conduct onsite evaluations of consumers in crisis. In many settings the logistics and economics of this charge are either impractical or even impossible. Many psychiatric crisis services have been forced to reduce their services by either decreasing the coverage hours when psychiatrists are available or decreasing the level of the professional that conducts the psychiatric evaluation. Most crisis centers rely heavily on nurses and masters or bachelors level mental health professionals to conduct evaluations. Telepsychiatry represents a unique way for these crisis centers to do more with less by offering them access to emergency psychiatrists without having to carry the expense and overhead of employing full-time onsite psychiatrists on a 24/7 basis. Through partnerships with InSight, psychiatric crisis centers are able meet their charge of providing 24/7 access to the highest level professional available within behavioral health to conduct evaluations through a clinically proven system that is extremely cost-effective. InSight’s unique emergency telepsychiatry system can augment on-site services by serving as either the primary or secondary method to access psychiatry for coverage in the daytime, evenings, nights, weekend, or even holidays. Further, this application of telepsychiatry has proven particularly effective in augmenting the work of onsite psychiatrists and has improved the success of many facilities in recruiting and retaining excellent onsite psychiatrists by offering a support mechanism that reduces onerous after-hours call obligations for onsite staff psychiatrists. Telepsychiatry for Commitments InSight and its team of telepsychiatrists have been using telepsychiatry within the voluntary and involuntary commitment process since 1999. While each state’s civil commitment process is unique, InSight is sensitive to the nuances of and importance of the regulations that govern the civil commitment process and has worked collaboratively with state governments, judiciaries, departments of mental health, law enforcement, and consumer advocate groups to jointly develop appropriate policies, procedures, regulations, and practice guidelines that effectively and appropriately integrate telepsychiatry within the commitment process. Typical Equipment Setup Most psychiatric crisis centers will require a mobile televideo equipment setup that can be mounted to an IV pole or rolling cart so that the video unit and the telepsychiatrists will effectively be brought to the patient. Depending on the technical capabilities and infrastructure of the facility, these systems may be set up to operate wirelessly or would be configured to be physically plugged in prior to the encounter. For emergency telepsychiatry evaluations, onsite staff such as a nurse, social worker, or mental health tech must be available to initiate the televideo interview and should remain with the consumer throughout the interview. As the interview concludes, the telepsychiatrist will communicate directly with the onsite staff to collaboratively discuss disposition and next steps. Resources and Documentation |
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