Question 1

Has research been done to prove forensic telepsychiatry works? What’s the evidence base?

Accepted Answer

Yes, telepsychiatry has been comparable to in-person care among inmates in jail, prison, and correctional facilities. Video visits with telepsychiatric evaluations are used used to treat inmates with a variety of psychiatric illness in a range of severity, including severe mental illness. Decades of studies demonstrates telepsychiatry’s usefulness.

Vacancies and staffing issues in correctional facilities can impact access to care. Physical space requirements, security requirements, and correctional work culture pressures discourage healthcare providers from working in the correctional facility environment.

Telepsychiatry fills these vacancies, can ease burden on clinicians and providers, and takes less physical space than having more personnel on-site.

With the adoption of telepsychiatry, inmates can be seen early in their incarceration. Patient satisfaction has been shown to be high in forensic psychiatric patients with remote video visits. Acceptability has additionally shown to be high amongst jail personnel.

A meta-analysis — a study of multiple studies — looked at telepsychiatry used in acute settings, including inpatient units. They showed that the quality of clinical interaction is similar to in-person face-to-face encounters, and that telepsychiatry has been cost-effective.

Sources:

Kaftarian, Edward. "Lessons Learned in Prison and Jail-Based Telepsychiatry." Current psychiatry reports 21.3 (2019): 15.
Salmoiraghi A, Hussain S: "A Systematic Review of the Use of Telepsychiatry in Acute Settings" Journal of Psychiatric Practice. 2015; 21 (5):389-93
Brodey et al, 2000. Satisfaction of forensic psychiatry patients with remote telepsychiatric evaluation. Psych Services: Oct 51(10): 1305-7.
Leonard S: "The Successes and Challenges of Developing a Prison Telepsychiatry Service" Journal of Telemedicine and Telecare. 2004; 10 (S1): 69-71
Zaylor C, Whitten P, Kingsley C: "Telemedicine Services to a County Jail" Journal of Telemedicine and Telecare. 2000; 6 (S1): 93-95

Question 2

Why are mental health problems pervasive in correctional facilities?

Accepted Answer

There is a growing scientific consensus that proper mental health care is one of the most important parts of rehabilitation for incarcerated individuals. Mental health treatment is one of the most effective components in reducing the likelihood of repeat offenses. Although mental health disorders are neither a necessary nor a sufficient factor in either criminal activity or violence, mental health issues undoubtedly contribute to the likelihood of running afoul of the law.

In the United States, there are more mentally ill people in correctional facilities than there are in mental health hospitals. Many criminal offenders struggle with mental illness and wind up in a correctional facility, and many incarcerated individuals develop psychological conditions as a result of their confinement. The rate of mental illness in prisons may be as high as two to four times greater than in the general public.

Providing proper mental health services to people in jails, prisons, halfway houses and other facilities helps everyone. Inmates get the psychiatric care that they need to become more productive members of society. In addition, the risk of suicide and other dangers can be mitigated, and healthy inmates are less likely to be involved in altercations with guards or other inmates while incarcerated.

By giving your correctional facility access to telepsychiatry, you can provide the mental health care that your inmates both need and deserve, without incurring the risk, inconvenience, and cost of either transporting inmates to treatment centers or transporting mental health professionals to your institution.

Question 3

How can telepsychiatry help your correctional facility?

Accepted Answer

Orbit Health brings the most qualified mental health professionals right to your facility, without the need for in-person contact. Telepsychiatry allows your facility access to qualified, capable psychiatrists, including specialists in the field of incarceration, located anywhere around the country. Telepsychiatry offers benefits such as:

You are not limited to the services of the nearest mental health treatment center.
Doctors are not put at risk by being placed in direct contact with inmates.
Increased access, including compliance with state and federal health regulations, at a reduced cost.
Reduced gaps in care: Get help from experts in post-traumatic stress disorder, incarceration, violence, gender transition, and any other specific issues faced by your inmates.

Question 4

How can forensic telepsychiatry help your case? Which forensic issues?

Accepted Answer

In many cases, forensic evaluations and testimony can be accomplished remotely via videoconferencing. Forensic telepsychiatry makes sense, and it saves time and money. Attorneys and judges are increasingly accepting of the concept of forensic telepsychiatry as a convenient and effective way to utilize expert testimony.

Orbit Health can provide teleforensic experts to help sort through the following forensic issues:

Competency to Stand Trial. In matters involving criminal defendants or other parties who lack mental capacity, a forensic psychiatrist can evaluate whether the party possesses the mental faculties necessary to stand trial on their own behalf.
Insanity Defense/ Criminal responsibility. Crimes of passion often turn on the mental state of the defendant. A forensic psychiatrist can evaluate whether a defendant possessed the mental capacity to understand the consequences and morality of their actions, or whether they should be subject to a lesser penalty or alternative treatments instead.
Civil Commitment/ Involuntary treatment. Forensic psychiatrists evaluate whether individuals could pose a danger to themselves or others in order to inform a court’s decision as to the wisdom and morality of involuntary commitment to a psychiatric institution. A remote telepsychiatrist can perform an evaluation of an elderly or disabled individual and offer an opinion as to their mental capacity. Such opinions form the basis of whether an adult or elderly person should be placed under the legal care of another.
Competency to Make Treatment Decisions. End of life care is complicated at the best of times. When an injured or ill person appears to lack the ability to make competent decisions about their own health, it is important to have a psychiatrist evaluate their mental faculties and their emotional state. This can be accomplished remotely via telepsychiatry, wherever the patient is located.
Worker’s Compensation and Torts. Injured parties, whether they suffer a physical injury, a psychological injury, or both, require expert evaluation and testimony to prove or disprove their case. A forensic telepsychiatrist can evaluate the extent of their injuries and the emotional trauma connected thereto. Forensic psychiatrists can provide vital insight and opinion as to whether an injured worker possesses the capacity to return to work or should instead qualify for disability benefits.
Violence Risk Assessment. Judges often rely on forensic psychiatrists to evaluate the propensity of a defendant for violent action when deciding upon bail. With telepsychiatry, your defendant will have access to the most qualified and most neutral evaluation in order to ensure that the principles of justice are not violated.
Child custody and visitation. Child psychiatrists can play a vital role in determining the healthiest placement for children of divorce. With Orbit Health, the best child psychiatrists can be brought in remotely for an unobtrusive evaluation and opinion.
Psychic injury. A forensic psychiatrist can remotely evaluate a plaintiff following a traumatic event to establish the extent of their emotional trauma and provide an expert, reasoned opinion as to the severity of their psychic injury, all without the expense of flying a medical professional to your location.
Mental disability. Disability is available for mental and emotional disorders as well as physical ailments. Telepsychiatrists can remotely evaluate applicants regarding whether they are capable of working or should instead receive disability benefits.
Malpractice cases often turn on the credibility of each side’s expert: Was the medical professional’s conduct appropriate, or did they violate standards and norms? With telepsychiatry, the strength of your expert opinion will not depend solely on which licensed psychiatrists simply happen to be in your region.
Juvenile justice. Experts are often employed in cases involving juveniles to establish the mindset and maturity of juvenile defendants and opine on whether they should be tried as adults
Other issues: Probate/ Testamentary Capacity/ Undue Influence; Defense Base Act (workman’s comp for military contractors); Sentence Mitigation; Personal Injury; PTSD; TBI (traumatic brain injury); IME (Independent Medical Examinations); Fitness for Duty; Sexual Assault; Sexual Harassment; Immigration (Asylum, Trafficking T-Visa, VAWA); Intoxication/ DUI/ DFSA (Date Rape); Suicide

Question 5

Why choose Orbit Health for your correctional facility?

Accepted Answer

Orbit Health is different from other telepsychiatry companies because Orbit Health's primary mission is to end the cycle of mass incarceration of the mentally ill. Led by the world’s leading experts and pioneers in correctional telepsychiatry, Orbit Health has specialized knowledge, skill, and experience to provide the finest quality of services to jails, prisons, juvenile detention centers, and forensic hospitals.

Many correctional settings struggle to meet State and Federal mental health care mandates, often due to limited psychiatric resources. Patients behind bars struggle to achieve psychiatric stability, making it difficult to function in these settings and leading to worsening outcomes, such as rules violations and enhanced sentences. Time and again, Orbit Health has improved access to care while reduced patient backlogs, thereby helping facilities function safely and efficiently.

Orbit Health's goal is to ensure patients attain stability before, during, and after incarceration in order to achieve success in any setting. Mental and emotional stability reduces the rate of recidivism, and nobody in the world does this better than Orbit Health.

If you are looking for correctional telepsychiatry services for your facility, or you are a provider looking for a job opportunity in corrections, contact Orbit Health today!

Question 6

What is #endthecycle? Why provide mental health care throughout the legal system?

Accepted Answer

The sad reality is that jails and prisons have become the new asylums. According to the Treatment Advocacy Center, 383,000 individuals with severe psychiatric disease were behind bars in the United States in 2014- roughly equivalent to the size of the city of Cleveland, Ohio. It is tragic and unacceptable that many people who deserve mental health treatment are instead thrown behind bars where they are exposed to trauma and further deterioration.

At Orbit Health, we are determined to disrupt the cycle of mass incarceration of the mentally ill by inserting telepsychiatry at every stage of the criminal justice system. This ensures that people who are vulnerable to incarceration have access to the right care at the right time.

Why is it important to provide mental health care throughout the legal system? People who are in the active phase of a mental illness (psychotic, depressed, manic, etc), are not able to function appropriately within the legal system and can disrupt the courts and correctional facilities. By contrast, when people are adequately treated for the mental illness, they are better able to navigate within the legal system, care for themselves, and stay out of trouble.

Perhaps most importantly, we have an ethical obligation to take care of our fellow man to reduce suffering and protect our communities. Orbit Health is there to help people get the care they need, whether it is at the time of arrest, in court, behind bars, or on parole.

At Orbit Health, we believe that a healthier person means a healthier society. Its time to #endthecycle of mass incarceration of the mentally ill.

Question 7

How does telepsychiatry work for forensic evaluations?

Accepted Answer

Identify a small, confidential area in your forensic setting that has internet access, a desk, and a chair. We will place a video screen there and provide psychiatrists via high quality videoconferencing technology. We can use the facility’s existing computers or devices to stream a connection over a web-based telepsychiatry platform.

Alternatively, we can provide a portable device that is dedicated to telepsychiatry and is always on. The technologies we use are specifically designed for telehealth encounters and are HIPAA-compliant.

When the subject of the forensic evaluation is ready to be seen, our telepsychiatrist will appear on the screen to conduct an expert evaluation. Forensic evaluations can be recorded if given permission from the subject’s attorney or by direction of the judge presiding over the case. Otherwise, the session will not be recorded. After the session(s), the telepsychiatrist will prepare his/her forensic report.

Contact Orbit Health to Get Connected to a Qualified Expert Witness Today: If you have a pending legal matter that would benefit from advice, opinion or testimony from a qualified psychiatric expert, you do not need to rely on whoever happens to be located nearby. It does not matter if there are no such experts in your area. Orbit Health will connect you with a qualified, professional, and effective forensic psychiatric expert, transmitted to any location that has internet access. Reach out to Orbit Health to discuss your options for telepsychiatry today.