Free Mental Health Clinic transitions to telehealth amid pandemic

By Francie Williamson, Communications Coordinator, Department of Psychiatry

Since 2006, the Free Mental Health Clinic has been available to anyone seeking assistance—including those who do not have insurance or face other barriers to receiving care.

But volunteers from the University of Iowa Carver College of Medicine, who help run the Free Mental Health Clinic, realized they had to switch gears after the COVID-19 pandemic spread to Johnson County in March. 

The clinic has stayed open every other Saturday morning, but instead of holding in-person appointments in the basement of the Abbe Center in Iowa City, visits are now being carried out via telehealth.

“In order to practice good social distancing, we decided it was in the best interest of our patients and the volunteers to move it all online,” says Melissa Chan, 3Y, who has been volunteering at the clinic since her first year of medical school.

Shea Jorgensen, MD, 3R, who also has been volunteering at the Free Mental Health Clinic since she was in medical school, helped the students move the practice online. The appointments are carried out on the Zoom videoconferencing platform, and are HIPAA compliant.

Jorgensen says while there are positives to instituting telepsych, it can be a challenge.

“I think to see patients in their homes, we get a much better view of what their world looks like,” Jorgensen says. “I think the hard part is there's a lot of cues that you just don't quite get, not seeing someone in person. And I think from my perspective it is a little bit more difficult to engage the medical student in teaching.”

Chan says working with telepsych at the Free Mental Health Clinic has been helpful for her future career.

“This is a great introduction for those of us who participate to learn about how to operationalize telepsych on a much smaller scale, and ultimately, think about how it can be better integrated into our future practices,” Chan says.

Demand has gone up

The Free Mental Health clinic draws on volunteers from the university’s social work and pharmacy programs, in addition to medical students, as well as residents and providers from the University of Iowa Department of Psychiatry.

“We also utilize student interpreters and have interpreters available for Spanish, Arabic, and French,” Chan says. “Other languages may be available on request.”

Chan says previously, most of the Free Mental Health Clinic’s patients were from Johnson County. But after switching to telehealth appointments, more patients from around the state, in places such as as Des Moines and Davenport, have been requesting visits.

“We know there's an increased mental health need during this time, and people are quarantining at home and may not have access to their normal providers,” Chan says. “The transition to telepsych has been an incredible opportunity for the Free Mental Health Clinic to meet the needs of individuals outside of the Iowa City area.”

Before the pandemic set in, Chan says the clinic booked between 10 and 15 patients every other Saturday, but had a pretty high no-show rate. However, that rate has dramatically declined since the clinic instituted telehealth.

“We previously had done a needs assessment for the community, and that identified that transportation was an issue,” Chan says, which may be one reason that the no-show rate has gone down.

The waiting list for visits is now about a month out for both new and returning patients, and Chan says the clinic is looking for more mental health providers to volunteer their services.

“We don’t have enough psychiatrists or other providers that can staff,” Chan says. “Students have been very willing to volunteer. We’ve had a lot of them email us about how to get started or if they volunteered before, how to utilize telehealth so they can see patients.”

Chan says if more providers volunteer, the clinic could begin seeing a higher volume of patients.

“Our goal is always to meet the immediate needs of our patient and then ultimately connect them to the insurance, social support, and health care providers in the community who can care for them on a more stable and indefinite basis since our resources are limited,” Chan says.

The positives of volunteering

Chan says there are many pluses to working at the Free Mental Health Clinic.

“It is a great teaching opportunity for residents and attendings who miss having students in clinic. Our volunteers are eager to help and learn,” Chan says.

She adds that students have not been able to take part in their clerkships since mid-March, and many feel restless and helpless because they no longer have meaningful relationships with patients.

“I've found that for myself the Free Medical Clinic is a great way to fill that void, continue contributing to society, and learn medicine even if it is in a virtual format,” Chan says. “Our patients are extremely thankful for the support that we've provided especially during a time when many individuals are having additional stressors in their life like job loss and this pandemic which can worsen anxiety and post-traumatic stress symptoms.”

Monday, May 18, 2020