Telehealth for behavioral health care

Considerations for telehealth substance use treatment

• Use SBIRT. SBIRT stands for “screening, brief intervention, and referral to treatment,” and is a common way to assess a patient’s needs to determine and, if necessary, refer the patient for treatment for a substance use disorder.
• Familiarize yourself with medication-assisted treatment (MAT) and medication for opioid use disorder (MOUD) models. Medication-assisted treatment is an evidence-based approach that combines behavioral counseling or talk therapy with the use of prescription drugs to curb opioid or alcohol cravings. Medication for opioid use disorder is a treatment approach that focuses on the use of prescription medications without behavioral health therapy to treat patients with an opioid use disorder.
• Aim for integrated care. Coordinating primary care with behavioral health increases access and improves care coordination. Integrated care often combines in-person treatment with telehealth.
• Recognize individuality. Tailor and integrate your treatment approach to meet the needs and preferences of your patient.
• Reduce Stigma. Discrimination and judgment are major barriers to patients seeking treatment. Remember that substance use disorder is a health condition and the words you use and how you communicate with your patient will impact the effectiveness of treatment.
• Be conscious of language and educational barriers to accessing care. Offer materials accessible in different formats and multiple languages. Use both images and words in your materials to address different patient literacy levels.
• Prioritize patient monitoring. As with any vulnerable patient in your practice, conduct a suicide screen at every contact for those at elevated risk. There are a number of suicide prevention methods that can be used if a patient is at risk of suicide.
• Review rules and regulations for prescribing controlled substances via telehealth. Make sure you follow the correct steps and comply with the appropriate laws to prescribe suboxone or other drugs, which are commonly used to treat opioid dependence. Identify vendors and local sites for patient drug testing as needed.
• Hire support staff. Some patients with substance use disorder may not have access to a phone or a personal computer. Support staff such as case managers can provide more hands-on help such as calling in prescriptions and connecting patients to treatment centers and social services.
• Focus on long-term, continued treatment. Get permission to continue follow-up contact with your patients. Schedule the next session before ending each telehealth appointment, if possible.