Shelter Residents
Counseled Via TV
(September 17,2004 - Arlington, Texas) -- One by one the Arlington Life Shelter residents file
into a small room and talk to the television, knowing they'll get answers.
Not just answers, but prescriptions for medications to treat depression,
schizophrenia and other severe mental illnesses. Since telepsychiatry, which
uses closed-circuit TV to link patients with psychiatrists, was introduced at
the shelter two years ago, more than 100 residents have received treatment to
help them get on with their lives.
"When a homeless person is looking for a job while dealing with a mental
illness at the same time, the faster they get help, the sooner they're on the
road to stability," said Donna Nichols, the Arlington Life Shelter's director of
program services. "An active mental health disorder limits their ability to cope
and function."
Through the telepsychiatry program, adults from the Arlington Life Shelter,
the Women's Shelter and the Salvation Army are able to talk to a psychiatrist
without traveling to Fort Worth. This year, Mental Health Mental Retardation of
Tarrant County, which provides the telepsychiatry service, added an on-site
nurse to work with clients. Twice a week, a therapist is at the shelter for
psychiatric evaluations and other services.
About 50 percent of shelter residents have some type of mental issue, and
most are coping with more than one challenge, said Tony Maclin, a therapist with
MHMR of Tarrant County.
A major loss -- whether it is a job, a home, a family member or a
relationship -- can trigger depression in anyone, Maclin said.
"Someone in a shelter experiences at least two out of four of those," he
said. "Often they start to feel like the cards are stacking up against them."
With telepsychiatry, they can get the help they need quickly, under one roof.
Residents can get an evaluation in the morning, see a psychiatrist in the
afternoon and get their medications in three to five days, Maclin said.
It used to take six weeks to navigate through the system and finally see a
psychiatrist. Then the resident had to get transportation to Fort Worth for
their appointment. Follow-up visits were also difficult to keep.
With the telepsychiatry program, residents are quickly stabilized, rather
than having a mental health condition that interferes with their employment,
Maclin said.
In the past, clients with mental illnesses often got jobs but couldn't keep
them, because they couldn't deal with conflicts on the job or they got mad and
quit, Nichols said. With medication, they are better able to maintain
employment.
One woman with bipolar disorder and a long history of illicit drug use
changed dramatically after she began taking medication.
"She had erratic behavior and a communication style that was very
aggressive," Nichols said.
"Afterwards, her demeanor became calmer and she wasn't as desperate."
Telepsychiatry at a shelter makes services accessible to those who are at a
higher risk for mental illness and might never get help if it was not readily
available, said Dr. Christopher Thomas, a professor of psychiatry at the
University of Texas Medical Branch at Galveston.
But quick and easy access does not mean sacrificing the relationship created
between a psychiatrist and patient.
Studies have found that patients feel just as comfortable with a therapist
through telemedicine as they do in a face-to-face setting, Thomas said.
For some patients, it offers advantages over an office visit.
"There are disorders where patients have fears and anxiety around relating to
others," Thomas said. "Teleconferencing provides them with a little more
control."
At the Arlington Life Shelter, residents seem relieved to get the help they
need, Nichols said.
"Half the time, when we sit down with somebody and start talking to them,
before they get through, they break down and cry," she said.
By Jan Jarvis
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