Skip to main content
Open access
LETTERS TO THE EDITOR
Published Online: 10 May 2021

Child Telemental Health ‐ Moving Us Forward

Publication: Psychiatric Research and Clinical Practice
We appreciate the article “Children and Telehealth in Mental Healthcare” by Hoffnung et al. (January 27, 2021) highlighting the need to continue and enhance these services. In contrast to the findings from their Rockland County, New York‐based clinic, 96.5% White and “heavily influenced by Orthodox Jewish and Hasidic populations” (1), we report a more robust level of utilization of telehealth (TH) psychotherapy and psychopharmacology services for both children and adults from our Rockland County‐based New York State Office of Mental Health Clinic. Our clinic serves a population of a socioeconomic level similar to Hoffnung et al.'s, but more racially and ethnically diverse (30% White, 25% Latinx, 7% African American, 2% Asian, 36% Other). Out of a total of 8502, the total EMR‐recorded visits from beginning to end of the same three time periods, adult visits increased (2108 pre‐lockdown; 2172 lockdown; 2463 post‐lockdown) as did child visits (586 pre‐lockdown; 548 lockdown; 625 post‐lockdown). Admissions to the Clinic (196) also exceeded discharges (144). Both adults and children increasingly utilized TH rather than in‐person face‐to‐face sessions (FTF) during the pandemic (pre‐lockdown 0.7% adult, 0% child; lockdown 82% adult, 71% child; post‐lockdown 86% adult, 74% child). Both adults and children also increasingly utilized TH rather than FTF for psychopharmacology (pre‐lockdown 0% adult and child; lockdown 70% adult, 53% child; post‐lockdown 85% adult, 82% child). As Hoffnung et al. point out, their conclusions are limited by “lack of diversity within the study sample” such that “the likelihood of cultural mediation remains substantial.” To test this hypothesis, we surveyed 65 Ultra‐Orthodox Hasidic parents in surrounding neighborhoods receiving child support services and found that 0% of their children possessed their own phone, with or without video capabilities, and few (3%) had access to a tablet, laptop, or desktop at home to participate in TH sessions in contrast to the children in our clinic, who typically used their own familiar, private, and video‐capable smartphones during TH visits. Nevertheless, 100% of parents surveyed reported that they would be open to trying video‐based TH for their children if devices were made available only for a time‐limited, therapeutic purpose. For example, the Hasidic organization Welltab was founded in April 2020 to loan‐free, secure tablets to families who wanted to connect with COVID relatives alone in the hospital (2). An intervention for Hoffnung et al. to consider would be the provision of loaned, culturally sensitive, web‐blocked tablets to enrich the salience of the child telemental health encounter and promote greater engagement in more creative therapeutic stories, somatic activities, and interactive games compared to the traditional telephone conversation.

Footnote

The article that is the subject of this Letter is available here: https://doi.org/10.1176/appi.prcp.20200035. The Response to this Letter is available here: https://doi.org/10.1176/appi.prcp.20210011.

REFERENCES

1.
Hoffnung G, Feigenbaum E, Schechter A, Guttman D, Zemon V, Schechter I. Children and TELEHEALTH in Mental HEALTHCARE: what we have learned from COVID‐19 AND 40,000+ Sessions. 2021. https://onlinelibrary.wiley.com/doi/10.1176/appi.prcp.20200035. Accessed 13 Feb 2021.
2.
Helping patients and families communicate from a safe distance. 2020. https://welltab.org/. Accessed 13 Feb 2021.

Information & Authors

Information

Published In

Go to Psychiatric Research and Clinical Practice
Psychiatric Research and Clinical Practice
Pages: 142

History

Received: 13 February 2021
Accepted: 6 March 2021
Published online: 10 May 2021
Published in print: Fall/Autumn 2021

Authors

Details

Maxwell Zachary Price
Columbia College, Columbia University, New York City, New York, USA (M. Z. Price); VCS Mental Health Clinic, New York City, New York, USA (I. Laidlaw)
Ian Laidlaw
Columbia College, Columbia University, New York City, New York, USA (M. Z. Price); VCS Mental Health Clinic, New York City, New York, USA (I. Laidlaw)
LCSW‐R
Columbia College, Columbia University, New York City, New York, USA (M. Z. Price); VCS Mental Health Clinic, New York City, New York, USA (I. Laidlaw)

Notes

Correspondence:
​ Mr. Maxwell Zachary Price, Email ([email protected])

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share