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.