Experts warn telehealth alone may fail in severe mental health crises

Telehealth now reaches nearly half of American adults with serious mental illness, but clinicians warn a screen can stop being enough when a patient becomes unstable, Fox News reported.

SAMHSA data cited in the report show 48.3 percent of adults with serious mental illness receive some mental health treatment by telehealth. The Lindsay Clancy murder trial has put a public spotlight on virtual psychiatry. Associated Press testimony covered by Fox News said Clancy had 14 virtual visits with her psychiatrist over five months and never met that doctor in person, including an appointment the day before her three children were killed. Clancy has pleaded not guilty and her defense cites postpartum psychosis. The article notes the telehealth debate is broader than any one case.

Jonathan Alpert, a New York psychotherapist not involved in Clancy's care, told Fox News Digital that virtual therapy can work well and expand access, but the sicker and more unstable someone becomes, the less comfortable he is relying only on a screen. He said suicidal, psychotic, manic, or non-functioning patients may need in-person evaluation or a higher level of care.

Alpert noted hygiene, agitation, intoxication, and other cues can be harder to judge on video. Patients can also look composed for a short appointment while falling apart between visits. More appointments are not the same as more treatment if the person keeps worsening. He said clinicians should ask directly about suicide plans, know the patient's location during sessions, and sometimes gather information from family.

He also stressed that postpartum psychosis, with delusions, disorganized thinking, or hallucinations, warrants inpatient care and is not the same as postpartum depression. Overall, Alpert said telehealth is not the villain. The risk comes when virtual care continues alone after clear warning signs that safety and assessment need more than Zoom.