Strengths of Telehealth
Telemental health is as effective as in-person treatment for many evidence-based treatments. It provides several advantages over traditional in-person treatment methods that may be particularly appealing to firefighters, including:
- Increased access to underserved populations (geographically isolated, rural, disabled, injured)
- Flexible schedule that is necessary for fire service members who have demanding shift hours
- More privacy for clients (attend sessions from home)
- Reduced stigma of mental illness that is prevalent among fire service members – clients do not avoid the care that they need
- Decreased travel time
- Decreased child and elder-care costs
- Reduced emergency care costs (e.g., because clients do not delay care until the problem exacerbates)
- Increased client satisfaction
- Improved continuity of care (e.g., if the client relocates)
- Improved accessibility to specialists
Challenges of Telehealth
While telemental health has advantages, there are also some challenges.
- Telemental health can be frustrating if you are less familiar with it
- Technical difficulties on either end, especially if the groundwork has not been conducted to make it easier. (Troubleshooting)
- Your view of the client is limited, and you may miss out on clinically relevant behaviors (e.g., nervous skin picking) – avoidance (can see it more than hear it), safety behaviors that help to avoid (Telepresence
Many firefighters do not prefer Telehealth, as their jobs do not require much virtual work, so discussing hybrid or in-person options with firefighters is important.
Barriers to Effective Telehealth Practice
On average Telehealth tends to make treatment more convenient for clients, however, it most often creates more work for providers – they have to learn a new technology, and learn a new set of support skills, figure out how to effectively exchange materials at distance with their clients, merge the logistics of virtual client scheduling procedures with their in-person scheduling, figure out new insurance billing codes, implement new safety and emergency protocols for the virtual context, problem solve creative solutions for clients who do not have stable internet connections, and ensure their data is secure and their services are HIPAA complaint. Although, each component by itself it’s not a heavy lift, it adds up quickly for busy providers. Earlier, I said that Telehealth solutions have to be usable for clinicians to adopt and be successful with them, and I was referring to both the usability of the technology and to these process-related support procedures that are part of a healthy Telehealth infrastructure. That infrastructure is a resource like any other resource, it needs to be activity managed and assessed with program evaluation and ongoing tweaks and training to set clinicians up for success.
Check Your Knowledge
Question 1 of 3
Some advantages of telemental health over traditional in-person treatment methods include:
Question 1 of 3
Correct answer: (d) All of the above.
There are several advantages to utilizing telemental health over traditional in-person treatment methods. First, telehealth increases access to underserved populations who often face logistical barriers (e.g., transportation, childcare, employment) and access barriers (e.g., not knowing where to go, no local provider that is familiar with firefighter culture) to in-person mental health treatment. To address some of these barriers, telehealth allows for decreased travel time and childcare costs. Research on telehealth indicates that individuals receiving telemental health treatment rate their satisfaction as high as with in-person treatment and that they show a similar continuity of care in both telehealth and in-person treatment.
Question 2 of 3
Situations where telemental health treatment can be more challenging than in-person treatment include all of the following EXCEPT:
Question 2 of 3
Correct answer: (b) Clients tend to prefer in-person treatment over telemental health treatment and often drop out due to lack of personal connection.
Well-established research on individuals who received telehealth and in-person treatment have shown similar satisfaction in both methods and that individuals are just as satisfied with telehealth treatment. There is no evidence that clients drop out of telehealth treatment at higher rates than in-person treatment due to lack of personal connection (research actually shows that people stay in telehealth treatment longer due to addressing many barriers to treatment).
Question 3 of 3
True or False: Many firefighters do not prefer telehealth, so it is important to only offer in-person services to meet their needs.
Question 3 of 3
Correct answer: False
While some firefighters may prefer in-person services to telehealth, this does not mean that therapists should only offer in-person services. There are several techniques, outlined in this app, that can address barriers to telehealth treatment and lead to success in telehealth treatment. In many cases, firefighters will find a hybrid in-person/telehealth approach acceptable.