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Virtual Psychiatrist Visits: How to Make Them Work for You

Virtual Psychiatrist Visits: How to Make Them Work for You

Before the pandemic, speaking to a therapist or psychiatrist via video call was novel. Today, it’s pretty common. For example, a recent analysis found that video appointments in the massive Veterans Affairs Health Care System have increased from about 2% of all psychiatrist visits in January 2019 to 35% of those visits in August 2023.

What are the pros and cons of virtual psychiatrist visits? Does seeing a therapist or psychiatrist via video rather than in person affect your response to treatment? What do you need to know if you haven’t used virtual psychiatry consultations before? Below, Stephanie Collier, MD, MPH, a psychiatrist at Harvard-affiliated McLean Hospital, shares her expertise and insights.

What are the benefits of virtual psychiatrist visits?

Virtual visits are convenient for many people, including those who may have difficulty getting to an office or who live in areas where it’s not easy to find mental health providers.

“You can chat with your mental health professional in the setting of your choice, which may make you feel better,” says Dr. Collier. “You don’t have to worry about coming to an appointment and then coming home again. And you can be assured that your outcome will be similar to that of in-person treatment. For example, in a 2022 study of about 1,500 people, participants who were treated for anxiety or depression reported the same level of symptom improvement on standardized scales whether they received virtual or in-person treatment.”

How do virtual visits work?

A virtual visit with a mental health professional works similarly to a virtual visit with your doctor.

You schedule an appointment to speak with a professional, usually a licensed therapist, psychologist or psychiatrist. These people may have a private practice or work with your insurance or a hospital system. Or they may be connected to an online mental health platform. Often, you can read about their professional background, expertise, and other information to help you decide if they’re a good fit for your needs.

Just before your appointment, you’ll log into a specific video platform and then find yourself in a virtual waiting room. When it’s time for your session, the expert will appear on the screen and conduct a 30- to 50-minute session, depending on what you agreed to, just like an office visit.

Does your insurance pay for virtual visits?

Not necessarily. Make sure your sessions are covered. Medicare and Medicaid cover virtual mental health visits, but not all private insurers cover the service. Even if you think you’re covered, double-check in advance.

What should you check in advance?

Preparing for a virtual visit includes preparing for both a mental health appointment and a video meeting.

Review the instructions. The mental health clinician should give you instructions for accessing the platform where the virtual visit will take place. If you don’t have instructions, contact the clinician’s office or online service to obtain them.

Be sure to comply. The platform your doctor indicates for your session should clearly state whether it is HIPAA compliant to ensure the privacy and security of your information. If you don’t see any evidence of HIPAA compliance, ask your doctor about it or consider choosing a different mental health provider.

Take inventory of equipment. You’ll need a smartphone, tablet, desktop computer, or laptop to participate in a virtual visit with a mental health clinician. The device will need a camera, microphone, and internet connection. You’ll also need a quiet place (so you and the professional can hear each other) and good lighting (so the professional can see you).

Do a test run. Log in to the platform your doctor indicated well in advance of your appointment. Check if you need to update your software to use the platform. You don’t want any surprises right before the appointment. Try out the volume and your camera angle.

How can you make video sessions work well for you?

It may be easier to read body language and express yourself in person. But many people—especially younger people—feel very comfortable online. And others may find the technology and apps easier to navigate with a little guidance.

Here are some tips to make sure you're seen and heard.

Set a reminder to charge your devices. The device you’re using should be well charged or plugged in for the appointment.

Gather some supplies. You may want to have a glass of water, a box of tissues, and a pad and pen handy for writing things down.

Make a list of questions or topics that are on your mind. “Think of a few topics you want to discuss ahead of time so you can go over them during your session,” says Dr. Collier. “If you keep a journal or sleep log and the information is important, have it with you to the appointment.”

Be prepared to share your thoughts and feelings. You don’t have to have the whole conversation. Your therapist will ask questions and prompts to guide the session and help you open up about your feelings and experiences. For example, they might ask, “How have you been feeling since our last session?” or “What challenges have you been facing this week?”

If you’d like, ask a friend to accompany you. If you feel more comfortable with a friend in the room to support you or help you with technology, arrange this in advance. During your appointment, tell the professional that someone else is with you.

Be patient. Sometimes professionals are late. This means you may be stuck in an online waiting room wondering if the appointment is still valid. Dr. Collier advises waiting about 10 minutes and then leaving a voice message (if possible) or email for your professional explaining the situation.

Should you schedule another appointment?

If you feel like your appointment was productive, consider scheduling another appointment. Again, make sure your insurance covers it.

What if you didn’t “click” with the professional? “This is an important consideration because your relationship with your therapist is the best indicator of how well you’ll do in therapy. So try a few sessions. If you still think your therapist isn’t a good fit for you, it’s OK to switch doctors. Many telehealth platforms allow you to do this pretty easily.”

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