Question 1

I need help.

Accepted Answer

If you are an administrator seeking services for your healthcare organization or facility, please contact us.

However, if you are a patient seeking services for yourself or your family/friend, Orbit Health cannot provide care directly to you. If this is a medical or mental health emergency, please call 911 or go to an emergency room immediately.

Immediate help

Get immediate help through MentalHealth.gov's Immediate Help page.
If you or someone you know is suicidal or in emotional distress, contact the National Suicide Prevention Lifeline. This service is available 24 hours a day, 7 days a week. Staffed by trained crisis workers.
Are you a veteran in crisis? The Veterans Crisis Line is available 24/7 — by phone, text message, and online chat.

Learn more

Find out how to get help at MentalHealth.gov
Find a psychiatrist, and learn more about psychiatric topics, at the American Psychiatric Association
Learn how to find mental health help at Mental Health America

Question 2

Does working for the federal government allow you to see patients via telepsychiatry, wherever you are?

Accepted Answer

Working for the federal government does not necessarily allow you to see patients via telepsychiatry, wherever you are. While there are no absolute contraindications to patients being assessed or treated using telemental health, you have to check with your supervisor — and any applicable administrative rules and trainings — for these rules.

Ask your supervisor about federal telework agreements, contingency plans for persons who appear in-person or who are unable to connect by video, and whether support staff are available to guide your patient in case of an outage.

Furthermore, telemedicine requires you to know which state a patient is located. You would need to follow that state's licensing laws and regulations. Usually, this means you must have a license to practice in that patient's state, have malpractice cover your practice in that state. Some states allow for a single state license to cover multiple states — the Interstate Licensure Compact, for instance — but not all states participate in this.

Resources, such as the American Medical Association Telehealth quick guide, can help you determine which laws apply.

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 Orbit Health serve community mental health?

Accepted Answer

Orbit Health is a beacon for underserved communities. We have extensive experience providing essential 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. 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!

Question 5

What's the standard of care for telepsychiatry, compared to in-person care?

Accepted Answer

Telehealth is increasingly being adopted by providers, patients, hospitals, and clinics as a great way of providing access to much needed healthcare. Policymakers and lawmakers have generally fallen behind the current practice and therefore there can be some uncertainty around what standard of care should apply.

Moreover, “Standard of care” can be subject to interpretation based on several factors, including, but not limited to:

Specialty or subspecialty, as it relates to the scope of practice of the provider

The prevailing opinion in telehealth circles is that the standard of care should be based on the location where the patient is located, however, this is not a hard and fast rule. Each state has its own opinions about standards of care for telehealth and multiple jurisdictions can potentially apply.

As a provider, the best way to think about standard of care is to do what a reasonable and prudent provider do in similar circumstances. Reasonable and prudent care often depends on several components, such as:

Patient case factors- although there are no absolute contraindications for telehealth, in rare cases the patient might object to the use of the technology for reasons such as paranoia/fear about being recorded or the technology being hacked, or difficulty keeping themselves in the frame of the camera due to cognitive issues. Also, if the patient is intellectually disabled and does not understand what is going on, perhaps thinking that they are watching TV.
Setting to which care is being delivered- the environment is noisy, distracting, or not private, this can affect the quality of care provided.
Types of technologies being used- if the technology does not allow adequate audio or video, this brings down the quality of assessment and treatment.
Overall framework in which care is being provided- If telepsychiatry is conducted in the absence of other potentially important support for the patient.
Consent- consent requirements are determined by each state. Some states require specific verbal or written consent from the patient to conduct appointments via telehealth. Others do not have this requirement or have not opined on it.
Limitations around AIMS testing. There are ways to conduct AIMS testing remotely, although the provider should be cognizant of potential limitations and this should be factored in the standard of care.

Telepsychiatry, more so than other specialties of telehealth, offers almost the same level of services as onsite psychiatry. Therefore, the standards of care should be considered very similar. In fact, some state medical boards (such as the Medical Board of California) make it clear that the standard of care is the same.

In reality, what a psychiatrist can do remotely may vary somewhat from what can be done in person. For example, a psychiatrist examining a patient remotely through video cannot physically touch the patient to assess for physical conditions such as cogwheel rigidity. In these cases, psychiatrists rely on onsite staff or other ways of obtaining a reasonable amount of information to make a diagnosis and adequate treatment plan.

Ultimately, standards of care can be interpreted in a variety of ways, and telehealth makes it even more vague and sometimes confusing. Therefore, the provider should use their best judgment, considering clinical factors, their means to resources, and the overall nature of the care being provided.

Disclaimer- this article is our best effort to provide useful information and does not constitute legal advice. Please make sure to consult with entities such as state medical boards, their malpractice carrier, and potentially legal counsel prior to practicing healthcare.

Question 6

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 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.

Question 8

How can Orbit Health help your forensic evaluations?

Accepted Answer

Orbit Health brings qualified expert witnesses directly to your conference room and courthouse.

Many legal matters, both civil and criminal, turn on the opinions offered by expert witnesses. Whether a case involves the damaging effects of personal injury, the reasonableness of a medical professional’s diagnosis and treatment, or the proper operation of a piece of complicated machinery, expert opinions often form the backbone of each party’s arguments to the judge and jury. Experts in the field of forensic psychiatry, in particular, are necessary for a wide variety of legal matters.

Not every jurisdiction has access to every type of expert, however. Some parties and some matters cannot justify the expense of flying a medical professional thousands of miles to draft an opinion and testify. Moreover, with limitations imposed during the COVID-19 coronavirus pandemic and other natural disasters, it can be difficult, if not impossible, to bring an expert to the locale where a matter is taking place. Thankfully, with the use of telecommunications, you can now bring the expert to your conference meeting or courtroom immediately, efficiently, and with much less cost.

Orbit Health connects the best and brightest forensic psychiatric specialists from around the country to litigants in need of expert opinions and testimony, no matter their location, without all the extra expense and complication of travel.

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.

Question 9

How can I combat Zoom fatigue symptoms?

Accepted Answer

Videoconferencing and remote professional services are now a regular practice in many industries. However, these remote calls can lead to feelings of fatigue.

If you find yourself exhausted by all of the video calls in your life, here are a few tips:

Schedule “no meeting” blocks of time. Make sure there are parts of your day when you are away from a screen.
Avoid multitasking. When you are on a call, focus on the business of the call. Avoid pulling up a second window to read emails or conduct other work. Multitasking during calls leads to a loss of productivity and difficulty remembering what occurred in the meeting.
Limit the number of calls. Do what you can to cut down on your overall number of calls. Group calls with separate people or teams together where feasible and appropriate. If a video call is not actually necessary, resolve the issues via phone, email, or a collaborative document. Do not default to a video call for every type of meeting. If you are meeting a stranger for the first time, such as a networking connection, for example, video calls can feel personal and invasive; start with a phone call.
Take breaks. If your call lasts more than an hour, it is important to take breaks. Get up and walk around, use the restroom, get a glass of water. Everyone will have more energy and remain more productive as a result.
Turn off your self-view. Video call programs like Zoom default to displaying your own video as well as others on the call. Staring at your own face can be distracting and increase stress and anxiety. Hide yourself from your own view so you can focus on the other people on the call.
Limit on-screen stimuli. In addition to hiding your face and keeping other windows closed, do what you can to limit what you see on-screen. Encourage people to take calls in front of plain backgrounds instead of a room full of objects. Seeing five different rooms full of furniture can cause disorientation and increase mental fatigue.

Learn more in our complete article, "Videoconferencing Fatigue and What to Do About It."

Question 10

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