How Does Telehealth Work?

More Americans are recognizing the benefits of seeking treatment for mental health conditions, but a number of barriers — including awareness and stigma — continue to prevent people from reaching out for help. Many of those barriers may also be practical concerns: inability to move work schedules around for appointments or offices that are simply too far to reach due to limited mobility.

Programs like Telehealth are addressing these barriers that inhibit individuals from getting the counseling they need. Providing clients with online counseling and psychotherapy is a “real game-changer,” said Nadia Islam, associate professor of clinical practice at USC Suzanne Dworak-Peck School of Social Work and clinical director of Telehealth. But she adds that more people need to understand the benefits of this growing field in social work and mental health.

Islam, who also serves as faculty for USC’s online Doctor of Social Work program, and her colleague, Marissa Enriquez, assistant professor of clinical practice of social work at USC, spoke with the MSW@USC blog about the work Telehealth is doing and telehealth’s potential to help more people.

Telehealth uses videoconferencing to provide face-to-face counseling and psychotherapy for individuals and families.

“The technology requirements are pretty simple. The client must have a computer that is usually no more than 4 years old, that’s equipped with a webcam, mic, speakers and reliable internet connectivity,” Islam said.

USC uses a videoconferencing platform that meets federal security guidelines for privacy and encryption and is compliant with the Health Insurance Portability and Accountability Act (HIPAA). Enriquez, who is the licensed clinical social worker (LCSW) lead for Telehealth’s Monterey County program, adds that the program is continuing to develop its technological capabilities.

“Now we’re able to see clients who are going to be participating from their own devices and that can range from their smartphones, tablets and laptops,” she said.

Unpredictable work schedules, transportation problems and lack of child care are frequently cited as reasons people don’t seek mental health treatment.

“What we’ve found is that for the most part these are clients who would not opt to seek services in a traditional brick-and-mortar facility,” Islam said.

Telehealth not only helps address these barriers, but also offers a sense of privacy for many individuals.

 “There still is substantial stigma around mental illness and seeking mental health services. So clients will tell us that they appreciate the opportunity to connect with a mental health provider from their own home. They don’t need to explain where they’re going to anyone else in their household,” added Islam.

Potential clients call Telehealth’s number (866-740-6502) to speak to one of the client navigators who will answer any questions about the program’s services. The client navigator will also ensure that the caller is a California resident; the clinic is only authorized to provide care to residents of the state.

“We’ve worked with diverse individuals from a range of backgrounds in the seven years since Telehealth was founded,” said Islam. “We’ve worked with clients living with chronic and severe mental illness, including bipolar disorder, major depressive disorder, generalized anxiety disorder, PTSD — sometimes for years.”

Clients may also be referred to Telehealth from partner programs, including the Los Angeles County Department of Mental Health and Monterey County Behavioral Health.

“With Monterey, we’ve received referrals because they feel the client or the patient is a good fit,” Enriquez said.

Services are offered in English and Spanish as weekly appointments for a total of 12 sessions or more. A combination of licensed clinical social workers and MSW interns work with clients.

Once an appointment has been scheduled, a provider and client may connect from separate locations via a computer, tablet or smartphone. Clients can attend from a private location such as their home or in professionally supervised offices called “tele-suites.”

Community-based agency partners provide the tele-suites, which are dedicated offices that protect the client’s privacy and enable clients to use the agency’s technology, internet connectivity, and a private room.

 “Telehealth has been able to set up these tele-suites in the communities where maybe those individuals don’t necessarily have the technology or privacy to connect to sessions at their home,” said Enriquez.  “That’s a really nice way to go into communities where people are in need but who might also be limited financially.”

Since launching in 2012, Telehealth has served more than 2,000 clients in almost 20,000 sessions.

“We’re able to offer individual therapy to clients ages 12 years and above,” Islam said. “Our eldest client was 92 years old.”

The clinic has served diverse client populations with various needs, including students; parents of children with special needs; survivors of intimate partner violence, sexual assault and human trafficking; transitional age youth involved in the public welfare system; and active military, veterans and their families.

Telehealth also offers therapy in English and Spanish, which opens up counseling opportunities to populations that may have never had an opportunity to seek services in their languages. Linguistically appropriate services can even help break down cultural barriers that exist for certain populations. 

“There are a lot of new individuals who are coming to therapy for the first time,” said Enriquez. “That doesn’t entirely surprise me. I am a Latina so I can see how even within the culture there is a lot of taboos and myths about mental health services. A lot of times, it’s something that is put on the back burner.”

By increasing access to individuals and to treatment, telehealth’s growth could be the answer to gaps in mental health care and other services. 

“One of the biggest draws and what brought me into Telehealth was the fact that there are people who might need therapy in their lives but don’t receive it,” Enriquez said.

Remote patients can more easily obtain clinical services, according to the California Telehealth Resource Center, which also notes that Telehealth allows more specialists to support more patients.

According to Islam, a portion of Telehealth’s services each year are reserved for pro bono care. 

 “All the people who recognize that they have a mental health concern and are willing to seek help for it but aren’t able to access it for whatever reason — I would want them to know about Telehealth as an option,” she added.

Citation for this content: The DSW@USC, the online Doctor of Social Work program at the University of Southern California.