COVID–19 Preparedness Guide for Mental Health Care Providers

As news about COVID–19 (novel coronavirus) is unfolding in real time, we recognize that mental health care providers are especially vulnerable to burn-out and compassion fatigue.

To support you, we’ve compiled a list of preparedness resources into an easily accessible and shareable guide. This is something that affects you just as much as your clients, and it’s our hope that this guide can help you to better manage anxiety by arming yourself with facts, plan for teletherapy appointments, and stay informed about medication supplies.

We’ll be making updates to this page as news unfolds, and we’d love to incorporate any resources or tips that you’ve found helpful. Email thedigest@helloalma.com to share.

Managing anxiety and fears of the unknown, both among clients and for yourself

1 — Limit news consumption to trusted outlets

2 — Educate yourself on the virus

  • Coronaviruses have been around for millennia. This strain is new (hence the “novel” in novel coronavirus) and we’re learning about it in real time. The podcast episodes here and here do a nice job of providing fact-based summaries of the virus.

3 — Recommendations for managing anxiety

  • Understand your fear and identify what triggers your anxiety. Limit your news consumption to trusted sources and be wary of platforms like Twitter, which thrive on hype, fear, and misinformation and make it easy to get sucked in.
  • Stick to a routine as best as possible, but be mindful of exposure risks. Find ways to exercise, talk to friends and family, get some fresh air. Structuring your days can alleviate cabin fever.

4 — Additional resources

Practice support and medication resources

1 — Have a teletherapy plan in place

  • The US Department of Health and Human Services announced that it will waive potential HIPAA violations for good faith use of telemedicine during the COVID–19 outbreak. That means that tools like FaceTime, Skype, and Zoom can all be used for teletherapy. [added March 17]
  • The New York State Department of Mental Health issued guidelines for the use of teletherapy tools during New York State’s declared disaster emergency, including a self-attestation to provide telehealth services for a time-limited period. [added March 11]
  • Congress passed an emergency funding package to address the spread of COVID–19 that includes temporarily lifting restrictions on Medicare access to telehealth services. [added March 13]
  • The APA published a comprehensive resource with temporary and telehealth licensing changes by state. [added March 26]
  • Understand the tools at your disposal. Phone calls, Google Hangouts, Zoom, and tools like Doxy are all simple to use and HIPAA-compliant. [revised March 4 to reflect HIPAA regulations]
  • This guide provides a comprehensive overview of what to expect and anticipate when transitioning to teletherapy. [added March 18]
  • Be sure to clarify how any of your policies regarding failure to appear for sessions and payments may be different for virtual sessions.
  • Consider your environment when offering virtual sessions. Conduct your sessions from a private room, ideally free of visual and auditory distractions.
  • Set the expectation that technical difficulties may occur. Communicating this ahead of time to your clients and practicing patience will go a long way. With that, have a policy in place for what to do if the connection can’t be repaired in time and the session is cut short, such as rescheduling or switching to the telephone.
  • Providers who work with children and adolescents may find this resource helpful. [added March 18]
  • While working from home, you may want to file a temporary change of address through the USPS. [added March 25]
  • The APA recommends asking clients to sign a supplemental informed consent document outlining policies and precautions as you begin hosting in-person sessions again. [added May 26]

2 — Monitor changes to medication restrictions

  • Insurance companies are monitoring the situation and are easing up on medication restrictions: UnitedHealthcare is allowing early prescription refills for up to 90-day refills and Aetna is waiving early refill limits on 90-day prescription medications from CVS. Blue Cross Blue Shield and Medicare are waiving early refill limits on 30-day prescriptions, and BCBS is encouraging members to get 90-day mail order refills. [updated March 18]
  • Encourage your clients to speak directly with their pharmacist to understand their options around refills and expiration dates. Some medications also have conservative expiration dates that can be pushed out, while others are more stringent. It depends on the medication and the condition being treated.

3 — Monitor medication supply chain updates

  • The FDA is monitoring possible medication supply chain disruptions.
  • At-risk medications include heparin and antibiotics like penicillin, whose supply chains and production are 100% based in China.
  • Encourage your clients to speak directly with their pharmacist to understand if any of their prescriptions are at risk for supply chain disruption and what alternative medications may exist.
  • On March 4, the House of Representatives introduced a bipartisan bill designed to mitigate future drug shortages and increase supply chain transparency. [added March 5]

4 — Additional reading

  • The APA issued a guide to preparing and protecting therapy practices during the coronavirus outbreak. [added March 6]
  • The NYC Department of Health is updating this website with resources for providers on COVID–19 preparedness. [added March 13]

How are you preparing?

We want to know what other mental health care providers are doing to prepare. What resources have you found helpful? Share tips and links with thedigest@helloalma.com and we’ll add them to this page.

“I ask any client experiencing flu-like symptoms, including a low-grade fever, to please stay home, and am offering telephone session as an alternative to office visits. All furniture and surfaces are sanitized after each client, sanitizing hand gel is available throughout my office, and I keep my office well-ventilated with both fresh window air and a HEPA air filter.” — Harley Sears, hypnotherapist (Kansas City, MO)

Record of changes

  • May 26—Added APA informed consent document for returning to in-person sessions
  • March 26—Added APA record of licensing changes
  • March 25 — Added information about the NYSDOH’s call for mental health care providers, Tempest’s digital recovery resources, and change of address information
  • March 18 — Added NYC COVID Worker Care Network, additional teletherapy resources, and early refills for prescription medication
  • March 17 — Added HHS enforcement discretion regarding telehealth
  • March 15—Added a New York Times article on breaking the coronavirus anxiety cycle
  • March 13 — Added additional telehealth considerations and NYC DOH’s resource for health care providers on COVID-19 preparedness
  • March 11 — Added information about New York State’s self-attestation for telehealth services during the declared disaster emergency
  • March 10 — Added information about NYC text hotline
  • March 6 — Added information about Ro’s free telehealth assessment and the APA’s practice protection guide
  • March 5—Added additional information about the COVID-19 virus and information about a proposed bill to manage medical supply chains
  • March 4—Revised teletherapy guidelines and added resource about talking about COVID-19 to kids

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A membership-based network of mental health care providers equipped with the tools and services they need to offer high quality, affordable mental health care.

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Alma

Alma

A membership-based network of mental health care providers equipped with the tools and services they need to offer high quality, affordable mental health care.

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