Though telemental health and telepsychiatry have played a critical role in the mitigation of the mental and behavioral health crisis, unfortunately both patients and organizations are now faced with another dilemma: How might people access virtual care services if they don’t have internet access or technology, or are homeless?

Delivering behavioral health services in places where access is limited was a challenge even prior to the pandemic. To address this, some healthcare organizations have formed innovative partnerships with local community services, homeless shelters, local libraries, and schools to give individuals who lack access the ability to receive treatment by helping patients obtain devices, notifying them of subsidized broadband access, and finding other creative alternatives.

In rural areas, it’s often a broadband issue rather than a lack of access to technology. The Federal Communications Commission’s 2019 Broadband Deployment Report states that 21.3 million Americans (6.5 percent of the population) are lacking access to high-speed internet and 162 million Americans are not using broadband speed. Many who don’t have access have been heavily relying on telephonic visits, especially in rural and frontier communities where broadband is not widely available. Telephone therapy is better than no therapy at all but being able to visually see a patient to observe body language and affect is incredibly important for behavioral health assessments and treatments, making video conferencing capabilities vital for telemental health and telepsychiatry.

Until this broadband issue is addressed, there will be an increased demand for in-person mental health care in these areas. Telehealth kiosks, which are small cabins that can be placed anywhere, can be a solution, especially in rural areas. These kiosks allow healthcare professionals including mental health providers to treat patients at distance using telecommunication technology and give patients quick access to a healthcare or mental health provider in a safe and confidential environment. They can be used in a variety of ways, including vital sign monitoring, teleconsultation, and as a digital pharmacy, and can be located in a wide range of public settings including hospitals, community centers, schools, retail stores, malls, office, airports, hotels, colleges, community clinics, and pharmacies. They’re typically outfitted with telehealth capabilities such as audio and video conferencing capabilities and have tools to track vital signs and other health data. These kiosks may include a credit card reader, handset for private audio, sanitation features, and customizable external kiosk branding. These kiosks can also store and forward diagnostic data, provide quick access to specialists, and grant provider access to patient data.

Several years ago, New-York Presbyterian started a telehealth kiosk program in partnership with Walgreens/Duane Reade, while Cleveland Clinic has a similar partnership with CVS. The Walgreens/Duane Reade telehealth kiosks are located in private rooms within the stores and offer examination, consultation, diagnosis, and treatment of non-life threatening illnesses and injuries. These kiosks are equipped with medical devices such as a blood pressure cuff, thermometer, a pulse oximeter that measures the amount of oxygen in the body and even a dermascope, which allows the provider to see high-resolution views of skin conditions. They’re best used for outpatient care needs by patients who are typically clinically stable, but suffer from psychiatric disorders requiring regular visits; they’re not designed to be visited by patients experiencing severe mental illness or episodes, which may be better cared for in an emergency department (ED), behavioral health crisis unit, or inpatient setting.

Telehealth kiosks help address the issue of increasing access to much needed mental health care, leading the way for early detection and timely treatment. When behavioral health issues are left untreated or are treated too late, it can exacerbate symptoms resulting in hospitalization and ED visits. Having the option of visiting a telehealth kiosk for mental health needs, especially in rural areas where access to care is limited, can have a significant impact on wait time for evaluation and treatment and individual well-being.

For more on the rising use of telemedicine, go here.

Anosha Zanjani, MArch, MSc, is a behavioral health design specialist at HDR (Los Angeles). She can be reached at