HJNO May/Jun 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAY / JUN 2021 39 For weekly eNews updates and to read the journal online, visit HealthcareJournalNO.com Despite logistical challenges, remote therapy improved engagement, mitigated symptoms and reduced repeated hospitalizations, according to a joint study by the Tulane University School of Medicine and the Tulane School of Social Work. The two schools teamed up on a study that examined the effectiveness of remote ther- apy during the first wave of the COVID-19 pan- demic, which began in March 2020. The study, “Psychosis, Telehealth and COVID-19: Suc- cesses and Lessons Learned from the First Wave of the Pandemic,” was recently published in the journal Disaster Medicine and Public Health Preparedness. Authors of the study include Serena Chaudhry, assistant professor of psychiatry at the Tulane School of Medicine; Tonya Hansel, director of the DSW Program at the Tulane School of Social Work; and recent MSW graduate Ariana O’Shea. Ashley Weiss, assistant professor of psychiatry at Tulane, and Grinasha Dillon also participated in study. “Louisiana has one of the highest rates of mental illness in the United States,” the study says. “Because people with chronic mental ill- ness seem to be more susceptible to pandemic- related stress, local mental health care providers are preparing for sustained spike in the needs of those with mental illness.” “Disruption in care, specifically for people living with severe mental illness, is concerning due to its effects on symptom exacerbation and relapse.” EPIC-NOLA provides comprehensive evaluation and treatment of adolescents and young adults who have recently begun to experience psy- chosis, which is often associated with emerging schizophrenia. The clinic also treats women expe- riencing perinatal mood and anxiety disorders. The study details the process of transition- ing from in-person patient visits to virtual treat- ment, beginning on March 13, 2020. The process involved enacting virtual teammeetings and mak- ing sure patients were equipped technologically. Patients also had to sign an electronic version of the telehealth consent form. EPIC-NOLA saw 137 patients a total of 545 times between March 16 and May 15, 2020, com- pared to 107 patients a total of 533 times during the same period in 2019. The no-show rate dur- ing the shelter-at-home period was 28 percent, compared to 32% the previous year. Of the 545 patient meetings, 411 were for individual ther- apy and 134 were for medication management. Researchers attribute the success of virtual treatment largely to the elimination of transpor- tation as a barrier to clinical care. “Poverty and limited public transportation are pervasive prob- lems across Louisiana and have proven to nega- tively impact patient care at the clinic,” research- ers said. “Engagement of patients who were at the clinic beyond the traditional two-year mark is also nota- ble, suggesting that telemental health may be a low-barrier clinical intervention for expanding and sustaining continuity of care.” Telehealth also enabled clinicians to learn more about patients, meet family members, get to know patients’ physical environments and observe patients’ moods in their home settings. Despite the many successes achieved dur- ing the first wave of the pandemic, there were challenges. For example, the process of acquir- ing signed consents virtually was onerous and required multiple follow-ups by clinic staff. Obtaining completed and signed paperwork for new patients proved to be equally difficult, the study said. The absence of a physical front desk also made it challenging for staff to check patients in and out, schedule follow-up appoint- ments and collect co-pays. Hansel commended the team at EPIC-NOLA for what she described as the clinic’s “innovation, responsiveness and dedication to individuals and their families experiencing psychosis. This popu- lation is a very difficult population to engage into treatment, even during normal times.” But whether remote therapy is preferable over in-person treatment remains to be seen. “I think preference may be more influenced by patient/ client choice,” Hansel said. “Youth tend to be more comfortable with telehealth services and given that young adulthood is a critical age for early psychosis intervention, telehealth services are unlikely to go away.” LPHI Releases Second Statewide COVID-19 Survey Data The Louisiana Public Health Institute (LPHI) released findings today from the second state- wide COVID-19 survey that was conducted in February 2021. The survey was commissioned by the Louisiana COVID-19 Health Equity Task Force and builds upon data collected in LPHI’s origi- nal COVID-19 survey that was conducted in June 2020. The main focus of the 2021 survey was vac- cine willingness. Both survey reports and addi- tional information are available on LPHI’s website at lphi.org/covid19survey. The survey broke down vaccine willingness into three categories: willing, hesitant, and unwilling. According to the 2021 survey data, 50% of Louisi- anans are willing to get the vaccine. 35% of survey respondents indicated that they are hesitant to receive the vaccine and 15% say they are unwill- ing to get the vaccine. Vaccine hesitancy is highest among white women and Black men, while unwillingness is highest among Black women. When looking at age, hesitancy is highest in men and women between the ages of 18 and 29. One in three respondents who identify as women and are of reproductive age say they are unwilling to get the vaccine. Location also plays a role, with Lou- isianans in urban areas indicating that they are more willing to get a vaccine than residents in rural areas. “This data helps us better understand vaccine willingness in Louisiana based on a variety of fac- tors and what information is needed to help Loui- sianans make an informed decision about getting the vaccine,” said Shelina Davis, CEO of LPHI. “We appreciate the support from the Louisiana COVID-19 Health Equity Task Force and hope that information from the survey will help organi- zations around the state with their COVID-19 out- reach and vaccination efforts.” The biggest motivator cited for getting the vaccine was “Protecting my family.” The biggest factors for hesitancy and unwillingness to get the COVID-19 vaccine are concerns about side effects, safety, and efficacy. When respondents were asked “What information about the Coro- navirus vaccine would like you like more of,” the COVID-19 vaccine safety, efficacy, and side effects were the top choices. When looking at sources of information about the COVID-19 vaccine, respondents indicated that doctors, healthcare providers, and friends and family were the most trusted sources. The least trusted sources are public figures, including