MinnPost interviews Kristi K. Phillips, chair of the American Psychological Association’s (APA) Committee on Rural Health, Phillips, who lives with her family in Litchfield, about the impact of telehealth in rural Minnestoa…
MP: I grew up in a small town. Back then nobody talked about their mental health. I’ve lived in the city for decades and many people here now seem pretty comfortable talking about mental illness. Are attitudes changing in rural communities?
KP: There is still a perceived and real stigma in rural communities about seeking mental health care. If you’ve ever been to a waiting room in a rural clinic, many times it’s like a social hour. It seems like everybody’s there. When you are wanting a zone of privacy around your mental health, this kind of thing makes people hesitant to go in.
One silver lining is telehealth. Since COVID hit, and I’ve been able to provide remote mental health services. Because of that, I’ve seen more famers and farm families than ever. More clients are willing to meet with me via telehealth because it offers more privacy. They don’t need to come into the clinic and risk seeing all their neighbors in the waiting room.
MP: Clearly the privacy that telehealth provides is a major plus. Do you see other benefits to remote therapy?
KP: Things are just so much more spread out in the country. I’ve had clients who’ve had to drive an hour each way to see me. At harvest time, that kind of time commitment is just not possible. Telehealth opens up new options. I can be working with patients wherever they are. They can have an appointment on their smartphones. My therapy appointments last 45 minutes to one hour. Telehealth makes that time commitment more obtainable for busy people. And we can schedule appointments at flexible times. I can work around their schedules.
MP: That flexibility is probably important, because people are juggling so much right now.
KP: Since I began offering telehealth, I’ve had almost a zero percentage of no shows. That’s completely the opposite of how it is for in-person appointments. If someone isn’t there at the scheduled time, I can almost always reach them: Most people carry their cellphones with them wherever they go. Maybe they’ve been distracted and forgotten their appointment. When I reach them on the phone, they’ll say, “I completely forgot the time. Let me pull over.” They can meet with me wherever they’re at.
MP: Is telehealth particularly helpful in Greater Minnesota, where mental health providers are few and far between?
KP: In Litchfield we are an underserved shortage area for mental health care. This is where I think telehealth can be especially helpful. If people don’t show for their in-person appointments, it is difficult to fill. We don’t have many of those kinds of issues with telehealth. People who are actually registered for appointments are getting seen. And we can see more patients in a day. People don’t feel like they have to take a half day off work just to travel to an appointment. They can say, “I’ll see you over my lunch hour,” and we can make that happen.
There are so many benefits that have come from telehealth. It’s unfortunate it took a pandemic for us to finally get comfortable with using these tools to make our lives better.
MP: After hearing your enthusiasm, it almost seems silly to ask you this, but do you see any disadvantages to telehealth?
KP: You do miss some of the micro-expressions that you’d observe in person. Some clients say they find telehealth impersonal or uncomfortable. But the benefits exponentially outweigh those types of issues.
MP: Do you hope to continue offering telehealth as an option for patients into the future?
KP: Yes. The majority of my patients want to be seen by telehealth.