The session starts with a presentation by Eugene Augusterfer on the basics of providing mental health services through tele-health. This presentation will help you understand what telemental health is; what technology is needed; what providers need to know to deliver telemental health effectively; and includes protocols for both providers and clients that will help assure success.
The National Capacity Building (NCB) Project at the Center for Victims of Torture is pleased to announce a two-part on-demand learning experience on using telehealth to provide mental health services for survivor of torture clients. This is an opportunity to learn about implementing telemental health from one of the foremost experts in the US on providing telemental health services and then connect with your colleagues to delve more deeply into the nuanced questions and dilemmas specific to delivery of services torture survivors via telemental health.
- Part One: Presentation and Interview by Eugene Augusterfer
- Part Two: Online Forum
We start with a presentation by Eugene Augusterfer on the basics of providing mental health services through tele-health followed by an in-depth interview where Mr. Augusterfer answers questions on implementing telemental health in SOT programs. This presentation will help you understand what telemental health is; what technology is needed; what providers need to know to deliver telemental health effectively; and includes protocols for both providers and clients that will help assure success.
About the Presenter
Eugene F. Augusterfer, LCSW, is the Director of Telemedicine for the Harvard Program in Refugee Trauma (HPRT) and a core faculty member of HPRT’s Global Mental Health: Trauma and Recovery Program. At HPRT, he has helped develop HPRT’s innovative model that addresses the need for sustainable care in post-disaster areas through the use of telemedicine, including mobile technology or mHealth. In addition to his telemedicine work with HPRT, he is actively involved in the broader field of telemedicine as the Chair Emeritus of the American Telemedicine Association Mental Health Group. As such, he has been instrumental in the design, development and implementation of telemedicine programs for a number of organizations, including governmental agencies and private industry.
Resources cited in the presentation:
- Improving access to care: Yellowlees, P., et al., Emergency telepsychiatry, Journal of Telemedicine and Telecare, 2008: 14(6); 277-81
- Telemedicine efficacy: Delaigue, S., Bonnardot, L., Steichen, O., Garcia, D.M., Venugopal, R., Saint-Sauveur, J.F., Wootton, R., (2018) Seven years of telemedicine in Medecins Sans Frontieres demonstrate that offering direct specialist expertise in the frontline brings clinical and educational value. Journal of Global Health, Dec;8(2):020414
- The role of digital health/mental health in post-disaster settings: Augusterfer, E.F., Mollica, R.F., Lavelle, J., Leveraging Technology in Post-Disaster Settings: the Role of Digital Health/Telemental Health, Current Psychiatry Reports, 2018 Aug 28;20(10):88.
- Telehealth as a medium to train providers in distant locations: Brandon, A.R., Song, L., Deal, A.M., Gellin, M., Sherwood, E., Rosenstein, D.L., Using Telehealth to Train Providers of a Cancer Support Intervention. Telemedicine and e-Health, 21(10): 793-800, Oct 2015
- Click here for the PowerPoint from the presentation.
- Telehealth Protocols: This is a brief summary of the recommended protocols from Eugene Augusterfer’s presentation.
- Telehealth Room Setup Checklist: This is a brief checklist of things to keep in mind as you set up your tele-health work space and prepare for your online session.
- HIPAA waiver: At this time, June 2020, there is some flexibility regarding HIPAA rules in tele-health. An FAQ from HHS on the subject is available here: https://www.hhs.gov/sites/default/files/telehealth-faqs-508.pdf
- HHS Telehealth website https://telehealth.hhs.gov/ provides information for both patients and providers including updates on policy changes regarding HIPAA flexibility during the COVID-19 Public Health Emergency.
- General Provider Telehealth and Telemedicine Tool Kit Centers for Medicare & Medicaid Services (CMS) https://www.cms.gov/files/document/general-telemedicine-toolkit.pdf
- The FCC COVID-19 Telehealth Program: The COVID-19 Telehealth Program provides $200 million in funding, appropriated by Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to help health care providers provide connected care services to patients at their homes or mobile locations in response to the COVID-19 pandemic. Unfortunately, this program is closed for new applications as of June 25, 2020. However, there is the likelihood that other Telehealth grants will become available as the COVID-19 pandemic continues.
- USDA – Distance Learning and Telemedicine Grant. This is primarily for rural beneficiaries but may be applied in small towns. The current application deadline is July 13, 2020.
- Your State and County:Keep an eye out for opportunities through your own state’s department of health or human services or your county health department.
Tele-therapy Software: Information on tele-health software platforms and tips shared with NCB by a variety of different organizations through various channels including NCB’s Advisory Group and listserv may be found here: https://healtorture.org/resource/information-tele-therapy-software
Providing tele-health services across state lines. You need to be licensed in both the state you are in and the state the client is in. Some states have modified their requirements for tele-health in response to the COVID-19 crisis. The Federation of State Medical Boards has created a list of states that have modified in-state licensure requirements. The list may be found here: https://www.fsmb.org/siteassets/advocacy/pdf/states-waiving-licensure-requirements-for-telehealth-in-response-to-covid-19.pdf
However, as Eugene Augusterfer points out, “If one is working across State lines, it would be prudent to check with the local Medical Board. New York and California tend to be the strictest on enforcement.”
There are numerous articles available online on how to conduct tele-health therapy, below are a couple.
- 2013 APA Guidelines for the Practice of Telepsychology
- Making Eye Contact Over Video in Telemental Health Services
Part 2: Telehealth Online Forum
Building on the video presentation and interview in Telemedicine in Mental Health (which we encourage you to view), NCB is providing an opportunity for clinicians to address telehealth questions specific to torture survivors, e.g., negotiating privacy; working with interpreters, dealing with triggering events; dysregulation; domestic violence; perceived fear and anxiety of remote communications/phone/computer being tapped. In this forum clinicians will be able to:
- share observations and adapted telehealth protocols
- ask each other questions
- contribute to the expertise we are all developing in using this new technology to serve survivors of torture
This peer-led conversation, conducted via a live online forum and technical exchange, will be a forum for colleague informational exchange and will not have a designated moderator. NCB staff will assist in facilitating and monitoring the conversation. The online forum will be open from July 6th to September 30. To participate in this forum, please click the button below.
Telehealth Online Forum