Advanced Telehealth Clinical Best Practices: Crisis Planning

1. Crisis
Planning
Shawna Wright, PhD

2. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
Telehealth.org, LLC
Consulting, Staffing, Credentialing and
Professional Training (CEs) in Ethically –
Required Competencies
www.telehealth.org

3. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
• WHO I AM: I am a licensed psychologist, not an attorney, physician,
marketing or information technology (IT) professional.
• MY GOAL: My goal is educational only. I will outline the issues and
alert you to what's happening in a way to help think through the
issues, help you move forward, and protect yourself as well as your
clients or patients. I hope to inspire you to use technology in ways that
help you, your clients and our profession. No warranty, guarantee, or
representation is made as to the accuracy or sufficiency of the
information contained in my presentation for your specific
circumstance. I assume no responsibility in connection therewith your
choices.
• YOUR PART: You are encouraged to seek specific advice from your
specific legal, regulatory, ethical and malpractice bodies before
offering any online services or programs to consumers. Get all such
opinions in writing, and have your informed, trusted, local, legal
counsel review them for their full significance.
Disclaimer

4. ©
1994-2022.
Telebehavioral
Health
Institute,
LLC.
All
Rights
Reserved.
4
Informed Consent
• Verbal and written informed consent
• Treatment and Technology

5. ©
1994-2023
Telehealth.org,
LLC
All
rights
reserved.
5
American
Telemedicine
Association Practice
Guidelines
• Local, regional, and national laws shall be followed
• Consent should include all information contained for
in-person care (structure/timing of services, record
keeping, scheduling, privacy, potential risks,
confidentiality, mandatory reporting, and billing)

6. ©
1994-2023
Telehealth.org,
LLC
All
rights
reserved.
6
American
Telemedicine
Association Practice
Guidelines
• Information shall be provided in a language that can
be easily understood by the patient
• Key topics that shall be reviewed with the use of
televideo/videoconferencing technology:
• Confidentiality and the limits of confidentiality in
electronic communication, an agreed upon emergency
plan, process by which patient information will be
documented and stored, the potential for technical
failure, procedures for coordination of care with other
professionals, a protocol for the contact between
sessions, conditions under which telemental health
services may be terminated and a referral made to in-
person care.

7. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
• Crisis planning needs to be considered and introduced at
the first contact with the client/patient and is often more
extensive than in-person treatment.
• Crisis planning should be developed according to the
patient’s location (i.e., supervised versus unsupervised
setting).
Crisis Planning
7

8. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
• Telehealth professionals need to know and understand
the jurisdictional mental health involuntary hospitalization
and duty-to-notify laws where the patient is receiving
care.
• In supervised settings, telehealth providers should be
familiar with the facility’s emergency procedures.
Crisis Planning
8

9. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
• In unsupervised settings, telehealth professionals may
request contact information of a family or community
member who could be called upon for support in case of an
emergency (e.g, The Patient Support Person”).
• In case the patient or the “patient support person” is
uncooperative during a time of mental health crisis,
telehealth professionals, crisis planning shall include local
emergency personal and knowledge of available resources
in case of involuntary hospitalization.
Crisis Planning
9

10. ©
1994-2023
Telehealth.org,
LLC
All
Rights
Reserved.
• Telehealth professionals should assess the limitations the
patient has in terms of self-transporting and/or access to
transportation.
• Telehealth professionals shall acquire telephone numbers for
local resources in the patient’s community and have them
readily available at the beginning of each session. Prior to
each session, the provider shall also determine the patient's
location and whether there have been any changes to the
patient’s personal support system or emergency
management protocol.
Crisis Planning
10

11. ©
1994-2022.
Telebehavioral
Health
Institute,
LLC.
All
Rights
Reserved.
11
Questions?

12. ©
1994-2022.
Telebehavioral
Health
Institute,
LLC.
All
Rights
Reserved.
12
Informed Consent
• Verbal and written informed consent
• Treatment and Technology