Discussion – Telehealth Visit

Discussion – Telehealth Visit

Telehealth visits allow for care delivery in a comfortable and familiar environment, especially in adolescent mental health care. From Jarrett, a teenage 16-year-old who was diagnosed with major depressive disorder after he threatened to commit suicide, telehealth has benefits. However, it is convenient since he can receive care without going anywhere, thus saving him time. Such an environment may help reduce stress and enhance the patient’s receptiveness during the session, which is critical in any therapy. As a technique, telehealth can help to fill the gaps in providing mental health care to people who have limited access to such services as Jarrett.

It is significant to recognize the limitations of telehealth in this framework. A potential weakness is the violation of Jarrett’s privacy, as he lives with his family in a small apartment. This may lead to a breach of the confidentiality expected during a therapy session when in the process of administering treatment for some of the sensitive mental health conditions. Furthermore, conducting the research without a controlled clinical setting may hinder the intake of psychosocial details and the determination of nonverbal signs that are important in assessing the mental state of a patient. Procedural problems such as unstable connection or Jarrett’s lack of experience with telehealth platforms might interfere with the call, which Gajarawala and Pelkowski (2021) claim would pose a threat to the therapeutic relationship.

This telehealth session, therefore, requires a proper setup to increase the chances of success. The workspace should be quiet, private, distraction-free, and as close as possible to a clinical setting (Jahncke & Hallman, 2020). To strengthen the above factors of a professional environment and to ensure that the session is productive, lighting and background should be observed. One also needs to remove any personal belongings that contribute to attaining a sterile environment that is not suitable for practice. To establish trust with Jarrett, he should be persuaded to move to an off room in his house where no interruptions would likely occur and, more importantly, make sure that the conversation is kept secret.

According to the available information, telehealth visits can occur through text, phone, and videoconferencing. Since Jarrett can precisely use the smartphone for these three, videoconferencing is the most suitable option. Video and visual assessment can be done through videoconferencing; this modality is crucial when it comes to the evaluation of mental health and demeanor, body language, and facial expressions (Chiauzzi et al., 2020). It also goes beyond text or phone, thereby making the rapport easier to build, especially when dealing with issues such as having to assess a patient after the patient has threatened to commit suicide. Other things to do with Jarrett and prepare him for the visit include ensuring that he understands how video conferencing works, telling him that he has to be alone when using it, and asking him if he has any questions.

Another crucial consideration, if the practice is being conducted via a telehealth platform, is seeking consent for Jarrett to receive treatment during the teleconference. Due to his age, consent should be obtained from the parent, who might be Jarrett’s mother or stepfather. According to Gajarawala and Pelkowski (2021), consent should include factors like risks and revenues connected with telehealth use and take into consideration the strengths and shortcomings of Jarrett’s care when using the telemedicine model for care delivery.

Subsequently, part of Jarrett’s care plan is social determinants of health that should not be ignored either. Nevertheless, his residential situation, family configuration, and the accessibility of a technical tool can significantly impair his aptitude for using telehealth services correctly. An understanding of these aspects will assist in formulating a proper treatment plan that is clinically and realistically feasible in the situation prevailing over Jarrett. Lastly, a safety plan is also crucial (Ferguson et al., 2021). This plan should include Jarrett, his family, and perhaps his school counselor. It should have plans for dealing with suicidal feelings and signs of suicidal risk. In this regard, all the caregivers treating Jarrett should be aware of the safety plan, especially when the child’s condition deteriorates.

References

Chiauzzi, E., Clayton, A., & Huh-Yoo, J. (2020). Videoconferencing-based telemental health: Important questions for the COVID-19 era from clinical and patient-centered perspectives (Preprint). JMIR Mental Health, 7(12). https://doi.org/10.2196/24021

Ferguson, M., Rhodes, K., Loughhead, M., McIntyre, H., & Procter, N. (2021). The effectiveness of the safety planning intervention for adults experiencing suicide-related distress: A systematic review. Archives of Suicide Research, 26(3), 1–24. https://doi.org/10.1080/13811118.2021.1915217

Gajarawala, S., & Pelkowski, J. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013

Jahncke, H., & Hallman, D. M. (2020). Objective measures of cognitive performance in activity based workplaces and traditional office types. Journal of Environmental Psychology, 72(3), 101503. https://doi.org/10.1016/j.jenvp.2020.101503

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Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising scholarly literature. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared. This discussion will support the professional formation of the nurse practitioner role.

Discussion – Telehealth Visit

Course Outcomes

This discussion enables the student to meet the following course outcomes:

• CO 1: Interpret subjective and objective data to develop appropriate diagnoses and evidence-based management plans for patients and families with complex or multiple diagnoses across the lifespan. (PO 5)
• CO 2: Utilize healthcare delivery system resources in a fiscally responsible manner in the diagnosis and treatment of patients and families across the lifespan. (PO 5)
• CO 3: Involve the patient and family in the formulation of management plans that align with their goals and perspectives of health and wellness. (PO 5)
• CO 4: Develop management plans based on current scientific evidence and national guidelines. (PO 5)
• CO 5: Incorporate cultural preferences, values, health beliefs, and behaviors into the care of patients and families with complex or multiple diagnoses across the lifespan. (PO 5)