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The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.

Everyone reacts differently to stressful situations.  How you respond to the outbreak can depend on your background, the things that make you different from other people, and  the community you live in.

People who may respond more strongly to the stress of a crisis include

  • Older people and people with chronic diseases who are at higher risk for COVID-19
  • Children and teens
  • People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
  • People who have mental health conditions including problems with substance use

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call

  • 911
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)

Stress during an infectious disease outbreak can include

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Additional information can be found at the Substance Abuse and Mental Health Services Administration (SAMHSAexternal icon) website.

Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.

Things you can do to support yourself

  • Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.

Below is a list of telehealth resources currently available! Click title of each section to visit website

Telehealth Resource Centers
In 2006, the federal Office for the Advancement of Telehealth initiated a regional telehealth resource center (TRC) grant program to provide support and guidance to telehealth programs. The twelve regional TRCs have a mission to serve as a focal point for advancing the effective use of telehealth and support access to telehealth services in rural and underserved communities. The TRCs have extensive telehealth experience and can provide services, resources and tools to both developing and operating programs. They offer webinars and many tools to assist in program development and success. Additionally, a National Telehealth Policy Resource Center and National Telehealth Technology Assessment Resource Center provide assistance to all of the regional TRCs.

American Telemedicine Association (ATA)
The American Telemedicine Association (ATA) is an international resource and advocate promoting the use of advanced remote medical technologies. ATA has a diverse membership of medical and mental health providers, healthcare systems, technology companies, and other entities interested in telehealth. The ATA and its membership work to fully integrate telemedicine into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world. The ATA website provides comprehensive information on developing standards, technology, applications, vendors, and other needs for telehealth providers. It also provides updates on the status of telemedicine across the states including policy and reimbursement.

American Psychiatric Association Telepsychiatry Web Page
The APA’s telepsychiatry web page contains their toolkit with multiple videos addressing general issues in the practice of telepsychiatry. It also has a monthly vlog (video blog) that updates members on timely issues from leaders in the field. The web page also allows members to pose questions to the Telepsychiatry Committee members for clarification.

Center for Medicare and Medicaid Services (CMS)
This website is managed by the Centers for Medicare and Medicaid Services (CMS). Telemental health providers should review information at the CMS website prior to any billing to determine any state-specific guidelines. Some client sites are eligible for Medicare/Medicaid’s originating site fees related to the videoteleconferencing (VTC) coordinator assistance. This site provides the definition of telemedicine, telemedicine terms, provider and facility guidelines, reimbursement and approach to reviewing telemedicine. It provides covered telehealth services for 2018 and 2019. This information is also helpfully summarized by the Center for Telehealth and e-Health Law (CTeL). The site also has a link to the Medicare Claims Processing Manual regarding “Medicare payments for Telehealth Services” (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf).

Center for Telehealth and e-Health Law (CTeL)
Licensure requirements are particularly important, both for interstate and international practice. CTel’s mission is to overcome the legal and regulatory barriers that impact the utilization of telehealth and related e-health services. It has established itself as the “go-to” legal and regulatory telehealth organization – providing vital support to the community on topics such as: physician and nurse licensure; credentialing and privileging; Medicare and Medicaid reimbursement; and private insurance payment policies. CTel provides a summary of findings regarding malpractice and telemedicine. CTel advocates at the national and federal levels for telehealth practice, including reimbursement.

Center for Connected Health Policy
The Center for Connected Health Policy is a nonprofit, nonpartisan organization working to maximize telehealth’s ability to improve health outcomes, care delivery, and cost effectiveness. CCHP actively researches and analyzes important telehealth policy issues, engages influential public and private sectors through analyses and reports, and provides key telehealth policy resources nationwide. CCHP acts as a catalyst for change by providing non-partisan, unbiased, researched-based policy analyses and bringing policy makers together with the private health care sector, health plans, academic researchers, and consumer health advocates to create successful models of connected care, that lead to more transparent systems of communication between providers and patients which can lead to better health outcomes and greater efficiencies in the delivery system.

Northern Arizona Regional Behavioral Health Authority (NARBHA)
This website focuses on Arizona but contains some training modules that are helpful to providers. For example, a slideshow presents the following topics: provisions of real world telepsychiatry, the practical considerations and of getting organized, telemedicine challenges, how telemedicine works and diagnostic instruments and exams. The website also has a demonstration of conducting the Abnormal Involuntary Movement Scale (AIMS) through videoteleconferencing (http://www.rbha.net/presentations/AIMSDemo/player.html).

Project ECHO® (Extension for Community Healthcare Outcomes)
This website provides information on the development of Project ECHO®, its rationale, its reach and opportunities for training. Project ECHO® uses videoconferencing to link specialists at academic medical centers in weekly virtual clinics, or teleECHO™ clinics, with primary care providers and other clinicians in multiple sites. Project ECHO® shares knowledge and expands treatment capacity with increased patient access and better care for more people. Project ECHO® programs in psychiatry have developed in multiple states and are growing globally.

Federation of State Medical Boards
This website addresses multiple issues related to the practice of telemedicine including state regulations, prescribing, and license portability for those seeking to practice telemedicine across states. 

Telemental Health Institute
This is a commercial website owned by the Telebehavioral Health Institute (TBHI). TBHI provides state-of-the-art in-person and online training in telebehavioral health. The TBHI offers courses in a variety of delivery methods i.e. webinars, individual courses, and group courses that cover a range of topics such as theory and practice, legal/ethical issues, reimbursement and advanced clinical telepractice models for success.

Telemedicine: How to do it Right!
David E. Roth MD, FAAP, FAPA
National Consortium of Telehealth Resource Centers Webinar    
This webinar describes issues in developing an authentic doctor-patient relationship when delivering care through videoconferencing. Practical steps in setting up the videoconferencing sites and establishing a therapeutic rapport are addressed.

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