How might we know what’s legal or ethical for telemental health if our legal and ethical codes are still vague?
The first thing to consider is that we, in mental health, are in a unique position. Of all the medical specialties, we are in the most disparate group, with several disciplines being represented. For example podiatrists, cardiologists, pediatricians and other medical specialties have associations that typically house the entire group, help establish norms, promulgate ethical standards, and work with legislators to develop regulations.
We on the other hand, are a professional group with different types of professionals, including (but not limited to) marriage and family counselors, pastoral counselors, vocational counselors, rehabilitation counselors, drug and alcohol counselors, employee assistance professionals, school counselors, as well as psychiatrists and psychologists. Then of course, we also have psychiatric nurses and social workers, and yet other groups. Each of these groups has at least one of their own professional associations, with their own ethical standards and guidelines. As for state regulatory boards, each subgroup of professionals can also be under the purview of an entirely different branch of the state government. For that reason, we cannot assume that what is legal or illegal for one discipline is true for all disciplines.
The same is true for ethical standards and guidelines. What might be considered unethical for one discipline can be the same across disciplines, but this isn’t necessarily true in all cases. For example, psychologists and psychiatrists have very different rules regarding how long a therapeutic relationship needs to have been terminated before the practitioner can start developing a romantic relationship with a former patient. For psychologists, it’s two years with other crietria to be met. For psychiatrists, it’s one day (last I checked).
All this is to say that some of our colleagues might get into rather heated debates unnecessarily. What might be legal and ethical for one discipline might be illegal or unethical for another. Those are my views. What are yours?