SUNY Upstate Psychiatric Nurse Program Fears Telehealth’s Uncertain Future SUNY Upstate Psychiatric Nurse Program Fears Telehealth’s Uncertain Future

SYRACUSE, N.Y. (NCC News) — Mental health services have changed drastically this year as virtual Telehealth sessions have become the norm during the pandemic.

Even the need for these services has risen in recent months, according to the CDC. John Ringhisen, a psychiatric nurse practitioner at SUNY Upstate, points to isolation resulting from quarantine.

“People are struggling more, people are at home more, people are depressed and anxious about the pandemic,” he said. “And so they’re seeking out those services more often.”

Ringhisen said the shift to Telehealth sessions has helped providers to combat this trend.

“In seeking out those services, we’re able to provide them in a more timely manner because the logistics of having to come into the office, see somebody face-to-face, have been removed from the equation,” he said. “All we have to do is sit down in front of a computer and talk to them.”

Part of what’s made this transition possible for Ringhisen and the Psychiatric Nurse Practitioner Fellowship Program he directs is the Coronavirus Aid, Relief, and Economic Security Act passed by Congress in March.

This legislation included changes to how reimbursement is registered for telehealth services. Usually, virtual sessions would receive a lower amount than those registered as in-person office visits, but this gap was closed in response to COVID-19.

“So the business model, as far as how much money we expect to get in, how much money we have to pay our employees, how much money we have to keep this service going, didn’t change very much when we shifted over to a virtual format,” Ringhisen said.

With the next stimulus bill currently held up in Congress, though, it remains unclear whether these measures will be extended into 2021.

A return to the usual reimbursement codes could have a major impact on the fellowship program.

“If that legislation doesn’t allow us to continue billing in-office codes, it would cut the program in half in its growth,” Ringhisen said.

Candace Carter, a psychiatric nurse practitioner and current fellow in the SUNY program, worries what this may mean for the fellowship’s future.

“Realistically, there’s only three of us in the program right now. So if you half that, there’s no such thing as one-and-a-half people, right?” she said. “I don’t really know how much smaller it can go for it to be fiscally beneficial.”

The fellowship is a unique hands-on program, and is about to become the only fellowship program specifically designed for psychiatric nurse practitioners in the country, according to Ringhisen.

Only one other remains open in the U.S., a Duke University program, which is set to lose its funding in the next year.

This leaves SUNY Upstate alone in offering this expert training and supervision in a variety of patient settings and populations for psychiatric nurse practitioners. 

Beyond the specific impact on Ringhisen, Carter and the rest of the program, though, the consequences of the next bill, not including these telehealth benefits, will be much more far-reaching.

“It’s just evidence-based that there’s simply not enough mental health providers, period,” Carter said. “If you’re going to narrow that pool even further, it’s just going to be more people that don’t have access to mental health care.”

If Congress moves in this direction, it would seem counter to the current growth and trends of the field.

“I think it’s important it’s not only continued in the stimulus bill, but that it’s continued as status quo for how we do health care anymore,” Ringhisen said.

The increased accessibility of virtual sessions has allowed many people to receive treatment that wouldn’t have been available otherwise, be it because of prohibitive travel times, work schedules, etc.

“That’s the biggest benefit of telepsychiatry for the general population,” Ringhisen said. “Being able to just pull it up on your phone, your computer, and have a provider right there willing to listen to you.”

Negotiations over the next stimulus bill are still under way in Congress.

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