Residents turn to telehealth
Pandemic’s social, financial impact weighs heavily on county as lockdown extends beyond two months
By necessity, doctors and therapists have had to switch to telehealth to treat patients during the COVID-19 lockdown. But it’s looking more and more likely that “distance medicine” is here to stay.
That’s certainly how Jim LaGra e sees it. He’s executive director of Rappahannock-Rapidan Community
Services (RRCS), the non-pro t agency that provides help for those with behavioral health, substance abuse, aging or disability issues in Rappahannock, Culpeper, Fauquier, Madison and Orange Counties.
Since RRCS clinicians aren’t able to meet in person with patients, they’ve adopted therapy by videoconference. It took some getting used to — on both sides of the online interactions — but most have now reached a comfort level.
“Our people aren’t trained to be telehealth clinicians, but now they are
nding they can be just as e ective,” LaGra e said. “For some people, telehealth may never work. But there’s a growing segment of the population for whom it’s working well.”
One apparent bene t is that patients seem more likely to show up for video therapy sessions than those that require them to go to a clinic. That’s been the case at the Fauquier Free Clinic, where the typical show-up rate is 60 to 65 percent; last month, when patients began connecting from home, it jumped to 89 percent.
“Behavioral health really lends itself to remote delivery,” said Sallie Morgan, executive director of the Mental Health Association of Fauquier County. “And, my feeling that it has great potential for rural communities has certainly been con rmed by watching the success of telehealth delivery at the Free Clinic.”
Morgan noted that during the pandemic, many insurers, including Medicare and Medicaid, have loosened their restrictions on what level of telehealth they will cover. The long-term prospects for online therapy, she said, could hinge on whether that latitude continues when the crisis eases.
In the meantime, organizations like RRCS are exploring new ways to use videoconferencing to provide help to those struggling in these uncertain times. It now o ers free Zoom support groups, ranging from sessions on substance abuse recovery or dealing with anxiety to training on “building resiliency.” (Times for the weekly meetings are on the RRCS website at www.rrcsb.org)
Unfortunately, those video sessions aren’t an option for people without a reliable broadband connection. That remains a hurdle, LaGra e acknowledged.
He pointed out that while the agency’s clinicians have been able to continue therapy for existing clients through phone calls, they feel it’s not appropriate to do the same with someone they’ve never met, not even online. So, those in need who call into the RRCS’ “Rapid Access” line are asked if they can do videoconferences. If not, their treatment is more limited. They can receive an in-person assessment at the agency’s clinic in Warrenton and get a caseworker assigned to them, but ongoing therapy isn’t an option for now.
“Better broadband is absolutely crucial for us if we want to address the health issues in these rural communities,” LaGra e said. “The idea of broadband being a nice luxury has to go away, and access needs to be seen as a necessity.”
He had the same message for participants in a recent Zoom session of the Rappahannock Roundtable, a monthly meeting of representatives of public agencies and nonpro ts that focus on the mental health and social needs of county residents.
“One of our biggest challenges is getting better broadband in Rappahannock and some of these other counties,” he told the group. LaGra e suggested that ultimately behavioral health treatment will become a hybrid involving both in-person and online counseling.
“It’s clear we can reach more people with telehealth,” he said.
Another topic raised in the Roundtable video meeting was the pandemic’s social and nancial impact on county residents as the lockdown extended beyond two months. Perhaps surprisingly, statistics from the Food Pantry show a recent drop in the number of families picking up food, and Berni Olson, community coordinator for the Rappahannock Benevolent Fund, said she’s not yet seen a spike in applications for nancial aid.
But that could change when the weekly $600 boost in unemployment payments stops at the end of July, suggested Gary Aichele, a member of the RRCS board and chair of the Headwaters board. He said the community must stay prepared for a surge in local families needing help, nancially and emotionally.
Aichele also said he believes many of Rappahannock’s teenagers are already feeling the e ects of having their lives so disrupted. “This is shaking them in a way we’re not aware of. Some of the kids I’ve talked to are very depressed,” he said. “They’ve expressed a sense of betrayal, like ‘What was I doing, trusting adults?’”
Kathy Sickler, the school district’s social worker who primarily works with what she described as “high-risk” students, told the group she’s worried about the long-term impact on the community’s young people. “We have so many kids in isolation,” she said. “When parents give them permission to get together, they celebrate. When teenagers celebrate, there are often high-risk behaviors.
“When we come out of this, there are going to be some consequences — maybe lifelong consequences.”
But not just high-risk students are feeling repercussions, noted county resident Brandi Day. Her son is a graduating senior.
“Students have had to nish the school year in very stressful circumstances,” she said. “Some are preparing to go to college and not knowing what’s going to happen in the fall. Kids at risk are even more at risk. Kids we didn’t have to worry about, we now need to worry about.”