TelePsychosis Consultation Service
Consultation service for patients with persistent psychosis
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Schizophrenia and other persistent psychotic disorders can be quite disabling. Veterans with schizophrenia have difficulty reintegrating into civilian life and building social, educational, occupational and financial foundations. The National TeleMental Health Center TelePsychosis service provides a secure clinical video-telehealth consultation and evidence-based recommendations for care and treatment to Veterans with psychotic disorders and their mental health clinicians.
Who would benefit from the TelePsychosis Service?
- Veterans who are not fully responsive to treatment as evidenced by:
- clinical problems, psychotic symptoms, or repeated hospitalizations
- inadequate response to 2 or more antipsychotic medications
- Veterans with medication side-effects
- Veterans who are difficult to diagnose
- Veterans being treated in rural locations or at community based outpatient clinics
- Clinicians with questions regarding clozapine or other treatments
What does the TelePsychosis Service provide?
Veterans continue with their local mental health providers/teams and utilize these consultative services periodically over approximately 6 months. Core components of the program include:
- Extensive evaluation and assessment including an in-depth medical record review, discussion with treating physician or prescriber and secure clinical video-teleconference interview with the Veteran addressing differential diagnosis, prior treatments, and common medical-psychiatric comorbidities. Recommendations for additional therapeutic interventions provided.
- Up to 6 additional encounters with the Veteran to provide further recommendations as therapies are changed, and to assess and encourage the Veteran’s ongoing readiness for change in treatment.
- Ongoing collaboration with and support provided for the referring clinician regarding treatment.
- Cognitive behavioral therapy for psychosis.
How do I start the TelePsychosis Service at my facility?
- Contact the National TeleMental Health Center at 203-479-8181.
- The National TeleMental Health Center coordinates all administrative aspects of the TelePsychosis service with your VA Medical Center’s Facility Telehealth Coordinator including the interfacility consult.
- An on-site clinical “champion” who reminds local clinicians about the availability of the National TeleMental Health Center TelePsychosis service at your VA facility.
Telehealth credit
Telehealth workload credit accrues at your VAMC/VISN without additional effort by your clinicians.CPRS documentation
Chart documentation - all clinical encounters are documented in your VA facility’s electronic medical record system and supplemented with email and telephone follow-up to referring providers as needed.Evidence supporting clinical videoconferencing interventions for psychosis and schizophrenia
- Safe and as effective as face to face encounters for mental health treatment (O’Reilly R et al, 2007).
- Assessments by videoconferencing are accurate and safe for psychosis (Sharp IR et al, 2011).
- Still under-used for psychosis in the VA (Grubbs KM et al, 2015) despite movement to increase use of telehealth to provide care to Veterans.
For additional information:
Alexander Young, MD, National TeleMental Health Center TelePsychosis Program Lead
Greater Los Angeles Veterans Healthcare Center, Mental Illness Research Education Clinical Center (MIRECC)
203-479-8181 | Alexander.Young@va.gov
Kurt Mischke Director of Operations, National TeleMental Health Center
VA Connecticut Healthcare System
203-479-8181 | Kurt.Mischke@va.gov
