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Mental health providers increasingly tapping telehealth options

Dr. La Keita Carter, owner and CEO of Institute for HEALing, a private mental health practice in Owings Mills. The practice moved to 100% virtual visits last year during the COVID-19 pandemic which has been good for the practice and patients.

Dr. La Keita Carter, owner and CEO of Institute for HEALing, a private mental health practice in Owings Mills. The practice moved to 100% virtual visits last year during the COVID-19 pandemic which has been good for the practice and patients.

High on the list of the pandemic’s unending ill effects is worsening mental health.

Social isolation, the loss of loved ones and, for many, loss of income have caused a spike in symptoms of depression and anxiety — difficulty sleeping, overeating, increased alcohol consumption, and more.

Earlier this year, the Kaiser Family Foundation released a study that found 41% of adults reported those symptoms, up dramatically from the 11% who reported them in the first months of 2019.

At the same time, finding help for mental health problems has become more of a problem, as traditional face-to-face counseling has practically disappeared.

All of this is nothing new to the people at the Institute for HEALing, a private mental health practice in Owings Mills.

Even before the pandemic, the institute was using virtual visits for many of its patients. Since the pandemic took off in March of last year, all visits have been virtual.

“We got started out of necessity – trying to help one patient,” said the institute’s owner and CEO, Dr. La Keita Carter, explaining how in 2018 virtual visits were set up to accommodate a young college student on the Eastern Shore.

But then the pandemic hit, Carter said, and in March of last year the institute switched to 100% telehealth.

The switch has been a boon for both the institute and its patients.

Business there is booming, with the number of visits soaring from 285 per week in March of 2020 to 450 per week now. Business has been so good that Carter hired more staff, including two practitioners, two interns and three front-desk people, boosting her total number of employees to 30.

“We are one of the only industries not laying people off,” Carter said. “The demand is so great.”

Demand for services, she said, increased at the start of the pandemic, rose again during the summer when social justice issues came to the fore – and rose again during the fall election season.

The switch to all-virtual visits was not simple. Therapists, used to treating patients in person, had to be specially trained on the ins and outs of doing the job on a screen.

Also, Carter said, certain conditions are especially difficult to treat virtually. The most difficult, she said, is psychosis, which the National Institute of Mental Health defines as a condition where “there has been some loss of contact with reality.”

The telehealth environment — a pet barking in the background or another person’s voice being heard in the background, for example — can trigger paranoia in those patients, she said.

Patients who are a threat for suicide or homicide, difficult enough to treat in person, are even harder to treat virtually, Carter said, as more factors can’t be controlled – things like a gun or knife sitting out of view.

To deal with that, the institute operates as a crisis team during such visits – pulling in other therapists to help with a second opinion or assessment during the session.

The Institute for HEALing is not the only mental health treatment facility in the state using virtual visits these days, and the switch is seen as a big plus in the industry.

“The expanded use of telehealth has been really important during the pandemic,” said Dan Martin, senior director of public policy for the Mental Health Association of Maryland. “It’s increased flexibility in the delivery of services and is protective of the providers and the public from exposure to the virus. Also, it’s increased overall access, which is one of the most important things.”

The need for mental health services has risen in the past year, Martin said, and is not likely to drop anytime soon.

“The need is only going to increase, and we are anxious to make sure people who need these services can access them,” he said. “And telehealth is one of the ways that we’re going to do this.”

His one caveat, Martin said, is the fact that virtual appointments are not an option for everyone – for those with no access to the Internet or many in rural areas, for example.

“At the same time we’re working to expand telehealth we have to make sure we’re still working to expand access to in-person services, too.”

Carter said that while her institute plans to offer in-person visits once the COVID-19 threat has waned, virtual visits will remain an option.

“Telehealth is definitely not going away,” she said. “Some awful, awful things happened during the pandemic. But there have been some bright spots, and one of them is people have learned to get the job done in health care.”

Another bright spot, Carter said, is that many people better understand their mental health now. “When you’re stuck in a house with your children and your partner, maybe your parents, you realize how important that family environment is and the impact it has on your mental health,” she said.


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