More N.J. crisis centers use online psychiatry sessions

Mental-health crisis centers in New Jersey are increasingly relying on “tele-psychiatry” — connecting patients and psychiatrists in an online setting rather than face-to-face.

While it has helped cut down on long wait times for patients, the method has some psychiatrists concerned.

Representatives of mental-health screening centers all over New Jersey say online sessions are the only way to get the job done — especially on weekends and in the middle of the night when patients experiencing a mental health crisis often have to wait an evaluation.

Being on call for psychiatric evaluations involves long hours and travel, and centers say there is a shortage of psychiatrists doing this work.

New Jersey law requires that patients in crisis be evaluated in a face-to-face setting, but 10 mental health-care providers have gotten waivers from the state for the online method. More are applying.

Tele-psychiatry is a useful tool, especially in rural settings, said Robert Bransfield, president of the New Jersey Psychiatric Association. He cautions, however, that privacy and security are major concerns.

Even if the online system is secure, patients may not perceive it as such, he said.

“A lot of times, we are dealing with a paranoid patient who might be in crisis,” he said. “Being reassured that there is a security system may not be sufficient.”

Online interactions are not typically suited for patients in crisis, according to Cheryl Kennedy, a psychiatrist with the University of Medicine and Dentistry of New Jersey.

“It’s fine when you have a calm patient who can answer questions back and forth and can keep their face and upper body language in the view of the camera. Agitated patients frequently are unable to cooperate with an exam,” Kennedy said.

Bransfield and Kennedy say tele-psychiatry isn’t quite ready for prime time. Many other issues, including reimbursement, legal liability, and licensing for doctors, have not been addressed in a cohesive, statewide manner.