Telehealth is making it easier for healthcare providers to diagnose and monitor patients without having to be in the same room with them. By obtaining information over the telephone or engaging in a videoconference, healthcare providers can offer assistance to a person in the comfort of their own home.
This benefit is particularly notable for people who suffer from mental illness and who may not feel comfortable being in public. Although there are many possibilities to help patients get the care they need through telemedicine, distance means people who are performing assessments on mental health patients may encounter new challenges. Keep reading to learn the subjects to cover during a mental health assessment performed by video or teleconference.
Begin by getting basic demographic information, along with health history. What you learn through those details could help pinpoint the reasons why a person is struggling with a mental issue. Make sure to ask if the patient is taking any medications and whether they’re prescribed or available over-the-counter. Some pharmaceutical drugs can cause side effects that make mental problems initially occur or get worse.
A person’s physical appearance is also an important indicator in a mental health assessment. Although it can be more difficult to evaluate if you can only see the patient through a small video screen, some of the things you can note include whether a patient’s hair appears to be washed and combed and whether their fingernails are clean and well-trimmed. Discharge in the corners of the eyes or mouth is cause for concern, along with excessive plaque build-up on the teeth. In severe cases of poor hygiene, lice nits could be evident in facial and scalp hair, and maggots may appear in open wounds. If you’re only speaking to a patient via the telephone, questions about how often they bathe can offer telltale information.
It’s also worthwhile to check for gait disorders, because they can be associated with a lack of motivation. You can do this by asking a person to stand up and walk across the room while they remain connected to you via teleconference and then timing how long the process takes. Another alternative is to ask a person to wear a pedometer and report back about how many steps were taken in a given period of time. It can also help if a patient records the amount of times they stumbled or lost balance.
Risk of Self-Harm
Gauge a patient’s suicide risk, too. That can sometimes be difficult to do without being face-to-face, but you can determine a lot about a person’s mood and intentions by listening carefully to their tone of voice and waiting to see how they respond when you ask for clarification about intentions to engage in self-harm.
If a patient is displaying obvious signs of psychosis or suicide risk and you cannot provide direct assistance, either due to distance or a lack of licensure to prescribe necessary medications, you have a professional and ethical responsibility to put the patient in contact with someone who can help them. Often, that may mean staying in touch until they get connected to a suicide hotline or a professional who can prescribe anti-psychotic medications, such as a psychiatrist.
Although telemedicine assessments are not easy, the information here should help you complete them confidently. Focus on the areas above to do thorough evaluations and more quickly uncover the issues that are causing distress for a patient.
About The Author
Dr. Caleb Hara has over two decades of experience in the telemedicine field. He aims to make patients feel empowered about health whether that means helping new mothers who are feeling overwhelmed by suggesting baby products available from The Health Counter or coming up with long-term mental health treatment plans.