- Sometimes a telehealth program’s best feature is its ability to start a conversation.
At St. Joseph’s Villa in Richmond, Va., a simple virtual visit platform has turned an eight-bed crisis stabilization center into an indispensable resource for families of children aged 5-17 who are struggling with depression and anxiety. The 32-inch television and audio-visual telemedicine feed enable these kids to talk to a child psychiatrist based in New Jersey, and to connect with counselors at any time during their voluntary 14-day stay.
In the six years that the program has used telehealth, roughly 88 percent of those adolescent patients have gone back to their home or a less-restrictive facility, while 12 percent have gone to a hospital or similar institution. And about 16 percent have come back to the program.
Officials say the program isn’t about medicine, but about compassion.
“We’re not a medical model – we’re more of a social model,” says Craig Hedley, Director of Community Partnerships for the children’s non-profit. “In some ways that’s easier and more comfortable for them. You can see it in how they respond.”
Launched in 1834 by the Daughters of Charity, it’s the third oldest children’s program in the country, now offering a variety of programs for thousands of Virginia children and their families each year. The crisis shelter is one of those programs, offering a voluntary place to stay for those between the ages of 5 and 17 who are struggling with anxiety and depression, don’t qualify for hospitalization and can’t afford the thousands of dollars in co-pays for private services.
Hedley says the program offers troubled adolescents a place to feel safe, and to talk to counselors about their issues. But those counselors are hard to locate, expensive to hire and can’t always be found when they’re needed the most.
Seven years ago, armed with a 10-year state grant, St. Joseph’s installed a telemedicine station and began connecting with a child psychiatrist Dr. Ashika Kapoor. Kapoor works with InSight Telepsychiatry and lives several states away. She handles most of the virtual visits during each patient’s two-week stay, and InSight provides 24/7 coverage when she isn’t available..
Hedley says he saw the difference in how the crisis center’s resident reacted to the technology.
“Kids prefer Skyping; they’re more comfortable with it than we are,” he says. “That makes them more (relaxed). And knowing someone is always available for them … really helps.”
The population served by St. Joseph’s Villa is growing at an alarming rate. The National Alliance on Mental Illness estimates that 20 percent of the nation’s teens are living with a mental health condition, and half of those diagnosed with a mental illness began to show symptoms by age 14. In addition, half of all teens diagnosed with a mental illness drop out of school, and three-quarters of teens now in juvenile justice programs are dealing with a mental health issue.
And suicide now ranks as the third leading cause of death among those age 14-24.
While the number of adolescents in distress is growing, the ranks of healthcare providers able to treat them are thinning. No state has an adequate supply of child psychologists, according to the American Academy of Child & Adolescent Psychiatry. And those who in the field are overworked, have waiting lists several months long and skew toward patients and programs that reimburse for their services.
That, Hedley says, leaves a large chunk of middle class America lacking the resources they need to treat an adolescent in need of mental health care.
“Who’s going to be able to afford thousands of dollars in co-pays?” he asks. “Who’s going to wait around six months to get an appointment? These kids are flat-line miserable and they need help. I like to tell the joke that I called the suicide hotline and was put on hold, but that’s kind of what it feels like.”
“We really are the first line of defense for these kids and their families,” he adds. “They’re stuck, and then there’s this a-ha moment … and things change.”
Hedley says St. Joseph’s focuses on the social aspects of treatment rather than the medical aspects. Everyone coming into the program does so voluntarily, and with support from the family. St. Joseph’s then works with the family, community resources school officials and others to create a support network for these patients when they’re discharged.
With a daily video link to specialists, he says, more of St. Joseph’s patients are prepared for what’s outside the program. They’ve had the opportunity to talk to someone who can bring them down off the cliff and into a more stable place, and they can talk in an environment that’s more comfortable for them, enabling them to open up more.
“This is cutting edge,” Hedley says of the telehealth platform.
Hedley expects the program, which received a telehealth innovation award in 2014 from the Mid-Atlantic Telehealth Resource Center, will continue well after the initial grant runs out. It will have proven its value, he says, in returning more children and adolescents with special needs to their families and their communities, rather than a hospital or institution.
He also expects to add telehealth services to several programs run by St. Joseph’s Villa.
“The ability to get these kids in front of people as quickly as we can is so important,” he says.