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Courts to Consider Telehealth for Mental Health Evaluations

A South Dakota task force will examine video visits as a means of clearing up the backlog of defendants needing a competency exam.

By Eric Wicklund

- South Dakota’s court system could turn to telehealth to ease its backlog of mental health evaluations.

With the state’s court system ordering four times as many mental competency evaluations this year as its one mental health facility can handle, a state task force will be looking to ways to speed up the process and keep prisoners from spending months in jail. On solution put forth is by offering evaluations via video.

“It’s possible right now to perform competency exams using telehealth, if the courts and counties will accept it,” Jay Gravholt, a spokesman for the Sioux Falls-based Avera Health System, recently told the Argus Leader.

The study comes at a time when the use of telehealth for behavioral and mental health services is on the increase.  While private clinics and licensed psychologists using the technology to improve and build their business cases, health systems are using the platform to treat ER patients needing real-time evaluations. That type of service isn’t that far removed from the competency evaluations required by courts.

South Dakota’s issues are really no different from those in any other state – an increase in criminal defendants needing a mental health evaluation before being scheduled for trial, compounded by an overworked state mental health system and a shortage of private psychologists available to do in-person evaluations. In this instance, the state’s sole facility, the Human Services Center in Yankton, has declared it won’t do more than 36 evaluations next year. This past year, South Dakota courts ordered four times that many evaluations.

State officials have said the courthouses are equipped with telehealth technology and that many judges already use it for other cases. Heather Covey, court administrator for the 14-county Sixth Judicial Circuit, based in the capital city of Pierre, told the Argus Leader the judges would likely consider telehealth on a case-by-case basis.

Avera Health, a 300-site system stretching across South Dakota, North Dakota, Iowa, Minnesota and Nebraska, would be an ideal partner in such a program, with a strong background in telehealth and mHealth care that dates back to 1993. The health system’s eCARE platform is billed as the one of the world’s largest, and offers platforms for ICU care, emergency services, consults, pharmacies, long term care and even correctional health services.

Steve Lindquist, assistant vice president of Avera Behavioral Health, told the Argus Leader the health system’s platform could handle competency exams, and that “there is a track record that shows these types of processes can be effective.”

Some questions remain. Officials would have to make sure patient privacy is protected, and that the defendants understand what’s being asked of them. Health officials also noted that the platform would need to be restricted to competency evaluations that determine whether a defendant is fit to answer the charges against him, and not for forensic evaluations.


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