Since the beginning of the COVID-19 outbreak, technology has become a necessary part of people’s everyday life—apps can be used to get groceries, communicate with family, or even become a doctor’s office.
For those of us living in the Denison bubble, we are confined to what the university is able to offer us, including access to wellness resources. A dire need for technological solutions during a pandemic and a rush to accommodate students’ wellness needs all across the world, however, can sometimes create more questions than solutions.
The stressors that come from quarantine, stay at home orders, and abruptly being sent away from college has led to increased mental illness in the United States throughout during the span of the pandemic. Telehealth, then, has become the perfect solution for those who want to continue their therapeutic treatment from the comfort of their own home.
Telehealth is an umbrella term for any kind of health-care done over remote electronic communication between two people—a provider and a patient. Telemedicine is between a nurse and patient, teletherapy is between a therapist and a client, the list goes on. Studies have been done to gauge the effectiveness of telehealth, and these studies concluded that the most positive results were specifically from behavioral health services through counseling and communication. However, there are a number of hoops to jump through when people try to access these resources, and even when institutions want to provide these resources.
For an established therapist, the transition to teletherapy can be extremely tricky to navigate. In addition to them having to learn how to do their job through a computer, there are very strict rules about providing therapy to a client who lives across state lines. Each state has different requirements to become a licensed therapist, and one has to go through a board in order to receive his or her title. For example: every counselor at Whisler is licensed in Ohio through the CSWMFT, or the Counselor, Social Worker and Marriage and Family Therapist Board. But the CSWMFT in Ohio has different jurisdiction as, say, a board in Virginia, a state that does not allow Ohio therapists to treat their constituents through telehealth. So not only did the therapists at Whisler have to tackle the implications of doing appointments over the internet, but there were still strict rules about where and when they were allowed to.
There are three options for teletherapy over state lines. There is unlimited care, limited care, and case management. Unlimited is full access to wellness resources, time-limited is permission from a state to provide therapy only during a state-wide emergency (COVID-19). Case management is, as Jack Wheeler an eco-psychologist employed through the Denison Wellness center explained, “identifying a need [for a client], and then finding resources where someone lives.” It is the last resort for a therapist who cannot provide for a client in a different state.
Wheeler spoke on some of the rapid changes for therapists on campus that resulted from the COVID-19 pandemic. “For the first two weeks after spring break we all did 13-hour trainings from different platforms to get as much information as we could,” he said.
Wheeler said even after he and his fellow counselors at Whisler were trained in telehealth, they had to call each state individually to see if they could provide services to their clients (in this case Denison students) or not. The counselors reportedly met every single day for an hour, trying to come up with ways to effectively provide care. Even then, some of them were forced to refer their clients to local resources, only able to provide them with case-management services. “It broke my heart to tell students I don’t have reciprocity,” Wheeler said, after explaining how hard it was for therapists so invested in their students to rely solely on laws and licensing rules to do their job. The rules are still changing every day from state-to-state as time-limited ordinances are expiring.
With that being said, there are still questions about the ethics of it all. Why do counselors do video calls instead of phone calls? What happens when a remote student in financial stress needs the free therapy from our institution but the best they can receive is case management?