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Discuss the benefits and drawbacks to a telehealth visit for this client.
There are both benefits and drawbacks to conducting a telehealth visits for clients. For this client in particular the benefits are: easy access without having the commute to and from the doctor’s office, cost effectiveness as tele visits are usually lower cost and the ability to be seen quicker. Drawbacks include: effectiveness of building trust, not being able to control the patient’s environment, and connection issues. Legal issues may also arise with tele visits, patients may accuse the provider of not being efficient due to connection issues and may also record the encounter without the knowledge of the provider, (Basavarajappa et al., 2022).
Describe how you will set up your workspace for the visit. What is or is not suitable to have in your workspace?
When setting up your workspace for a tele visit it is important to be mindful of your surroundings and what is in it. No visible patient information should be present or in view of the patient. The visit should be conducted in a closed private and quiet room free of distractions and noise such as music, notifications on electronics, TV, etc. The area should be neat and clean. You should have access to the current patients EHR and MAR for reference and to be able to document when needed. If you are not able to document at the current time when on the tele visit then a pen and paper should be readily available.
Jarrett has access to text, phone, and videoconferencing on his smartphone. Discuss which technology you would recommend for the visit and why? Discuss how you will support Jarrett in preparing for the visit.
With Jarrett having access to videoconferencing this is the technology I would recommend for this visit today due to the nature of his past medical history. It is already challenging to form a relationship bound with trust through technology and being able to see each other, make eye contact and ability to pick up on one another’s nonverbal cues is beneficial in this situation. Supporting Jarrett in preparation is beneficial for both him and the provider and helps to ensure there is no wasted time and that the time spent together is of quality. For preparation I would ensure he first has access to video, internet, and provide a link and time for the videoconference. I would also give a brief outline of what to expect and instruction such as explaining confidentiality and what information would be shared with his parents, ensuring he is in a private and quiet environment with little to no distractions and explain that I am here to support him. This helps to set the tone for the encounter.
Describe how you will obtain consent. Who must consent to treatment?
Prior to treatment and tele visit it is essential to obtain written consent from the parent or guardian, in this case the patient’s mother. This may be done electronically if available via a patient portal or via a secured link or email that can be signed via DocuSign. If needed the patients parents can physically drop off or fax the consent if need but again, this must be done prior to treatment.
Discuss how you will assess the impact of the social determinants of health on Jarrett’s treatment plan.
Social determinants of health impact the patients’ health outcomes and at times can impact negatively. In Jarrett’s case he is a teenage male that is living in subsidized housing living in close courters with his siblings. It is important to assess if Jarrett has access to clean running drinking water and healthy foods, overall health, his transportation situation to and from school, and his relationship with each family member. It is also important to assess how he is doing in school and race as teenage black males living around the poverty line have increased odds of having suicidal thoughts, (Wang & Wu, 2021).
Describe a safety plan for Jarrett. Who should be involved in the plan?
When treating those who have suicidal ideations it is imperative to have a safety plan ready that involves the patient, parent or guardian and practitioner. Others may be involved if they are trusted and agree to follow the safety plan. The safety plan should include warning signs of a crisis involving suicide, strategies for coping mechanisms, supportive persons, who to contact with phone numbers, when to contact mental health provider, and strategies of reducing or eliminating lethal means, (Ferguson et al., 2022).
References
Basavarajappa, C., Grover, S., Dalal, P. K., Avasthi, A., Kumar, C. N., Manjunatha, N., Sahoo, S., Saha, G., Mehra, A., Singh, O. P., Tripathi, A., Gangadhar, B. N., & Math, S. B. (2022). Perceived advantages and disadvantages of telepsychiatry – An online survey of psychiatrists in India. Indian journal of psychiatry, 64(1), 93–97. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_332_21Links to an external site.
Ferguson M, Posselt M, McIntyre H, Loughhead M, Kenny MA, Mau V, Procter N. Staff Perspectives of Safety Planning as a Suicide Prevention Intervention for People of Refugee and Asylum-Seeker Background. Crisis. 2022 Jul;43(4):331-338. doi: 10.1027/0227-5910/a000781.
Wang, G., & Wu, L. (2021). Social Determinants on Suicidal Thoughts among Young Adults. International journal of environmental research and public health, 18(16), 8788. https://doi.org/10.3390/ijerph18168788
