Demand for telemedicine services has skyrocketed in the wake of the COVID-19 pandemic and beyond. Many NPs, including psychiatric and mental health-focused providers, have gone digital. Patients are in search of mental health care from the comfort of home—giving NPs a clear path to fulfill the needs of diverse populations grappling with a spectrum of psychiatric conditions. If you are looking for ways to establish or enrich your remote medicine modalities, we’ve got you covered.
Delivering Comprehensive Telepsychiatric Care
The majority of patients, especially those dealing with mental health challenges, want to feel seen and heard by their healthcare provider. This can be extra challenging when seeing clients remotely, but there are a plethora of ways for NPs to elevate the quality of telehealth visits.
Establish rapport
Patients are more willing to open up to someone they trust. However, this can be challenged when the only interactions you have are through a screen. Your body language, environment, and tone should be warm, inviting, and professional. Invest in quality hardware, software, and internet service to prevent glitches, dropped calls, or lags. Be sure to maintain eye contact with the camera, avoid glancing at other areas of the screen like the clock or other programs, and silence notifications from other apps. Start with small talk, like “How is your day going?”, and really listen to the patient’s response.
Additionally, it may be worth it to acknowledge the potential awkwardness of remote healthcare. Say something like, “I know meeting online can feel different, but my goal is to make this as comfortable and supportive as possible.” Reassure patients about confidentiality and HIPAA compliance to build trust early on.
Related: Telehealth: Providing exceptional patient care remotely
Consider the unique needs of special populations
Geriatric, pediatric, and neurodivergent patients may have trouble adjusting to telemedicine visits. Elderly people may have a hard time navigating technology, so it can be helpful for your office administration to provide patients with simple instructions on how to access your online platforms. Children, adolescents, and neurodivergent patients may have limited attention spans, struggle with eye contact through the screen, or get distracted by other things in their room. For these clients, it can be helpful to tap into smaller cues when conducting assessments. Pay attention to subtle movements, body language, posture, and fidgeting. This can provide clues into the unique challenges of this patient without overwhelming or bombarding them with direct questions.
Maintain boundaries and professionalism
If you are conducting telemedicine visits from a home office, it can be difficult to separate personal life from work life. Avoid having a “busy” background on camera—personal mementos, maximalist decor, or a messy room can take patients out of “therapy” mode. Also be sure to dress professionally. Even through a screen, it signals respect and competence.
Prescribing via Telemedicine
The Ryan Haight Act traditionally required at least one in-person evaluation before prescribing controlled substances online, but temporary telehealth flexibilities (extended post-COVID) allow certain controlled medications to be prescribed via telemedicine under specific conditions. Hint: Fitzgerald’s DEA compliance course can help you stay in the know on regulatory considerations.
Some more fast tips:
- Conduct a thorough psychiatric assessment before initiating any medication. Use validated tools like PHQ-9, GAD-7, or MDQ to support clinical impressions.
- Gather comprehensive history: psychiatric, medical, medication, and substance use—especially for controlled prescriptions.
- Start low and titrate slowly, especially for new patients where in-person observation isn’t possible.
- Confirm patient understanding of dosage, side effects, and response expectations.
- Encourage medication tracking via journaling or digital health apps to monitor adherence and side effects.
- Schedule frequent early follow-ups (e.g., 2–4 weeks) when starting or adjusting medication.
- Assess side effects visually (e.g., tremors, sedation) and through verbal check-ins.
- Encourage patients to report physical changes or adverse effects promptly.
Key Telemedicine Takeaways
Switching to telemedicine can be a big adjustment for both NPs and their patients. Trial and error is inevitable, and it may take some time to solidify which telehealth platforms and appointment structures work best for everyone. Safety should be a priority. Make sure your patients feel seen and understood, and emphasize that they have the ability to contact you for help in the event of adverse medication interactions or times of mental distress. Tailor your approach to psychiatric care based on a patient’s unique challenges, personalities, and the mental health conditions they live with. With some time and practice, you can join the millions of NPs across the nation bringing quality care into the homes of their clients.
