Question 1

How can Orbit Health serve residential youth homes?

Accepted Answer

Orbit Health believes in protecting the health and wellbeing of our precious youth, especially those who have mental/emotional problems and developmental disabilities. Working in partnership with residential youth homes, Orbit Health has vast experience serving vulnerable youth remotely, through state-of-the-art videoconferencing technology (“[Telepsychiatry](https://www.orbithealth.com/what-is-telepsychiatry/)”).

At pivotal moments in a child’s journey, we are there to ensure high quality and trauma informed care. Our mission is to keep these children on the right path of life and out of the [cycle of mass incarceration](https://www.orbithealth.com/telepsychiatry-services/correctional-care/cycle-of-mass-incarceration-of-the-mentally-ill/).

To learn more, [contact Orbit Health today](https://www.orbithealth.com/contact-us/)!

Question 2

How can Orbit Health serve community mental health?

Accepted Answer

Orbit Health is a beacon for underserved communities. We have extensive experience providing essential [telepsychiatry](https://www.orbithealth.com/what-is-telepsychiatry/) services to community mental health programs such as county outpatient clinics, inpatient units, and crisis stabilization centers.

Our goal is to help provide essential psychiatric treatment to those in the community at risk for severe mental illness, homelessness, poverty, addiction, and [incarceration](https://www.orbithealth.com/telepsychiatry-services/correctional-care/cycle-of-mass-incarceration-of-the-mentally-ill/). We deliver high quality and reliable patient care remotely, through state-of-the-art videoconferencing technology.

Our services help community clinics and hospital function more efficiently and effectively, reducing the burden of serious mental illness on society.

To learn more, [contact Orbit Health today](https://www.orbithealth.com/contact-us/)!

Question 3

Are psychotic patients appropriate for telepsychiatry?

Accepted Answer

There is no absolute contraindication for telepsychiatry and virtually any mental health condition can be treated via telepsychiatry.  Generally, the concerns about psychotic patients becoming more paranoid or distrustful with telepsychiatry are overblown.

However, in rare cases, a patient may not be appropriate for telepsychiatry if they are truly fearful about a delusion that involves the camera or videoconferencing equipment.  Does this mean that telepsychiatry is inappropriate or impossible to effectively treat such as patient?  Not necessarily...

It is important to remember that psychotic patients can incorporate anything from their environment into their delusional beliefs.  For example, a patient may be delusional that they are being held captive in a secret Nazi prison camp. This does not mean that they should be discharged from the unit out to the street.  Likewise, a patient who has delusions about telepsychiatry does not necessarily fail to benefit from telepsychiatry.

Nevertheless, it is theoretically possible for a patient to be so paranoid about telepsychiatry that they become mute or refuse to participate in the telepsychiatry session.  If that same patient is willing to converse with a psychiatrist in the facility, then perhaps onsite psychiatry may be a more effective option.   This would be a clinical decision based on the case factors.  Ultimately, if the treatment team feels that the patient fundamentally cannot benefit from telepsychiatry due to their delusional beliefs about that modality of care, then other arrangements should be made to provide care onsite.

In summary, there are certain clinical situations where a patient's mental status or condition may require that arrangements are made for onsite psychiatric care.  However, this happens very rarely.  Overall, telepsychiatry is an effective option in the vast majority of mental health cases.

Question 4

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 5

Are there certain conditions that benefit more from remote care for group therapy?

Accepted Answer

There is insufficient research to determine if group therapy done remotely is more suited for a specific type of patient.

However, remote care is often less intimidating than being in person. For example, a patient with an anxiety disorder such as social phobia or agoraphobia may be reluctant to put themselves in front of a group of strangers for the first time.  They may be more likely to participate in remote groups instead.

Question 6

What is telepsychiatry?

Accepted Answer

Telepsychiatry is the delivery of psychiatric care remotely using technology, usually through videoconferencing platforms.  It can involve mental health evaluations, therapy, medication management, and patient education.    Telepsychiatry is the fastest growing sector of the telemedicine and is the future of mental health care.

Telepsychiatry is a form of telemedicine that generally refers to the delivery of psychiatric assessment and care via telecommunication, typically using videoconferencing software. The practice of telepsychiatry has been in development since well before the pandemic quarantines, as an effort to account for the millions of Americans who suffer from mental illnesses but are unable to get proper psychiatric care.

Telepsychiatry brings mental health care to individuals who are unable to see a medical professional in person for any of a variety of reasons, including the cost and availability of travel, incarceration, or contagion. Now, with shelter orders and quarantines keeping medical offices closed and people restricted to their homes, telepsychiatry provides a promising alternative to in-person psychiatric care.

Question 7

What group size is ideal for group therapy?

Accepted Answer

There is no hard and fast rule. It depends on the topic, instructor, and participants.

Nevertheless, the larger the group, the more impersonal it may feel.  Having a group size of 4-6 people makes it easier for the group to develop a stronger bond.

However, even a group of 15-20 people can develop a bond remotely, it just may take more time and effort to do so.  One advantage of a larger group is that an absence of one member may not have as much of an impact on the discussion.

Question 8

How can Orbit Health provide COVID-19 psychiatry services?

Accepted Answer

Identify a small confidential area accessible for clinical use. All you really need is 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 your 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. Clinical encounters are not recorded.

When the patient is ready to be seen, our telepsychiatrist will appear on the screen to provide expert clinical care. After the session, the telepsychiatrist will submit the clinical documentation directly into your electronic health record.

What are the advantages of Orbit Health Telepsychiatry?

* Providing telepsychiatry staff with expertise and training in COVID-19 and mental health
* Providing psychiatric medication management and psychotherapy
* Participating in treatment team meetings and consultation with onsite staff
* Increasing patient satisfaction
* Improving patient outcomes
* Reducing costs of recruiting, hiring, managing and retaining onsite staff

Question 9

Is telepsychiatry subject to specific guidelines and laws?

Accepted Answer

Orbit Health psychiatric professionals strictly adhere to the federal and state guidelines that apply to their practices.  Additionally, different states may implement and apply different guidelines specific to telepsychiatry.

For example, telepsychiatry practitioners must carefully follow laws that regulate prescriptions for controlled substances. This is done by a rule called the “Ryan Haight Online Pharmacy Consumer Protection Act of 2008,” enforced by the DEA (Drug Enforcement Agency).

The Ryan Haight Act requires a practitioner to conduct in-person medical evaluation before they can prescribe a controlled substance. Some exceptions apply for systems like federal healthcare providers at Indian Health System.

With the COVID-19 public health emergency, an in-person medical evaluation is not feasible. This is where telepsychiatry has a protective advantage for clinical staff and for patients. For instance, the DEA will allow prescriptions to be issued for audiovisual telemedicine communication.

Question 10

Do you see group therapy sessions on the horizon for telepsychiatry?

Accepted Answer

Most forms of mental health treatment can be equally effective as in person care, including group therapy.  Remote group therapy has been slower to take hold than one-on-one care given by psychiatrists and mental health clinicians.  However, as the world continues to embrace telehealth, group therapy is anticipated to become more prevalent.

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