Latest / Becker's Healthcare Behavioral Health / Using Telehealth to Diagnose and Treat Adolescent ADHD with Dr. Tracy Mullare of Iris Telehealth

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Using Telehealth to Diagnose and Treat Adolescent ADHD with Dr. Tracy Mullare of Iris Telehealth · Becker's Healthcare Behavioral Health

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  Hello, everyone. This is Erica Spicer Mason with
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  Becker's Healthcare. Thank you so much for tuning
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  into the Becker's Healthcare podcast series today.
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  So today, we're going to talk about diagnosing
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  and treating adolescent ADHD. And joining me for
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  this conversation is doctor Tracy Malair,
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  the senior medical director of physician services at
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  IRIS telehealth.
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  Doctor Malair, thank you so much again for
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  joining Becker's today and for talking about this
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  important topic. Really appreciate you being here. Oh,
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  thanks, Erica. I'm very happy to be here,
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  and thanks for shedding light on this important
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  topic today.
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  Absolutely. We're happy to do so. And before
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  we get into some of the more granular
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  details,
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  I wanted to see if you'd like to
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  share just a little bit more about yourself
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  and your work in health care just so
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  our listeners know where you're coming
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  from? Yeah. Absolutely.
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  My training, so to speak in health care,
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  I I'm a physician,
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  and I did my
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  residency training combined in pediatrics,
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  adult child psychiatry.
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  Have a real passion for working with kids,
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  and really love the intersection of physical and
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  emotional health and access to care throughout development.
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  So that training was really the sweet spot
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  for me,
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  and I've been practicing
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  now for seventeen years, which is really hard.
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  I don't to say, I don't know where
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  the time has gone.
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  I started practicing
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  specializing in adult and childhood eating disorders along
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  with continuum of care, both outpatient,
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  IOP partial,
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  and inpatient levels of care,
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  and then went on to
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  more specialty
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  adolescent
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  general residential and OCD residential and partial level
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  of care.
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  Along the way, I've also had the pleasure
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  of consulting with pediatricians in my state,
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  regarding their behavioral needs of
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  their patients.
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  And
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  for the last about seven years, it's been
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  my pleasure to be at IRIS Telehealth and
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  really
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  honing in my telehealth skills and working with
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  an organization
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  who shares the passion
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  for access to care for behavioral health needs
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  for children and adults.
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  So it's been a really fun journey for
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  me being able to work in different facets
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  in psychiatry.
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  Oh, it's great to learn more about you,
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  doctor Malera. So thank you so much again
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  for sharing.
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  And I know you mentioned at the top
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  of your response how you're really passionate about
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  access, and so it really seems like a
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  probably a great fit that you're on this
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  journey now to exploring the opportunities and telepsychiatry
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  and what that means for access and greater
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  care. So we'll we'll certainly get into that
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  some more.
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  But first, I wanted to start our conversation
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  off by just kind of acknowledging that we've
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  seen this pretty significant rise in pediatric
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  ADHD
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  diagnoses. You know, we see that in our
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  coverage at Becker's,
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  and other
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  publications in the industry.
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  And it's a trend that's really drawing
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  a national attention, and it's raising important questions
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  as well about how our system is equipped
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  or maybe not equipped to respond.
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  So from your vantage point, what are you
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  seeing as the biggest gaps or even pain
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  points in getting kids and teens that timely
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  and appropriate ADHD care?
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  Yeah. Thanks for that question.
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  One of the pain points of
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  the increased diagnosis is where to find care.
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  And to your point, the increased
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  number of diagnosis of ADHD, I think, is
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  is really multifactorial.
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  I think
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  response to academic demands. I think
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  there were aspects of the pandemic
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  where children were homeschooled
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  and parents
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  noted
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  symptoms and were still, you know, thankfully through
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  the pandemic,
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  but kids are
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  still, trying to catch up with social and
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  emotional
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  challenges faced during that time. And there are
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  many children and families still presenting for
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  diagnosis
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  and treatment.
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  And that has been a really big pain
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  point that I've been supporting,
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  my patients and families through.
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  I think having
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  limited access is
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  very frustrating for families
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  once they
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  step forward, take that brave step that
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  we need a little additional help and evaluation.
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  Too many times I hear I can't find
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  a specialist, or when I found a specialist,
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  there's a long wait list,
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  and that's been
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  really disheartening for for our families.
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  Absolutely.
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  Long wait lists.
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  And on top of that, you know, to
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  your point about families perhaps becoming more aware
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  of some of the struggles their children or
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  their teens are going through with mental health,
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  whether it be ADHD or something else. You
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  know, being able
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  to have more visibility into what's going on
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  and not being able to get the help
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  in a timely manner, I can only imagine
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  the frustration as a parent.
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  And and at the same time, as this
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  demand and, you know, increased diagnoses
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  are happening, I know the availability of behavioral
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  health providers is dwindling as well.
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  And I know this is also where virtual
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  models can certainly factor in. So can you
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  tell our audience a little bit more about
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  how telepsychiatry
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  can help to improve the ADHD care journey
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  for families and any impact you're seeing at
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  this time?
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  Yeah. Absolutely.
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  Because there is such a paucity of providers,
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  many many organizations,
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  whether that be the pediatric center, community health
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  care centers, academic centers,
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  just can't find the specialist they need to
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  treat childhood behavioral health disorders, ADHD included.
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  So it's really hard to find enough experts
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  in the field to meet the demand
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  so that by opening a virtual care model,
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  you are
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  finding specialty providers that may be from a
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  different area of the country that are able
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  to service
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  your community,
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  and really open up
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  availability,
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  thus decreasing
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  wait times for kids and families. So you're
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  providing the right care by finding the right
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  specialist
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  at the right time because you are decreasing
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  waiting times for families,
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  and that wait time has been such a
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  significant pain point.
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  It's really frustrating,
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  in pediatrics
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  because
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  development is such a rapid and fast thing.
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  So much development happens
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  within months of a child's life. So for
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  them to be suffering socially,
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  academically, or emotionally,
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  without help can really have a chronic impact
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  on their development.
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  And ADHD
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  symptoms
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  untreated can continue into adulthood,
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  really increasing vulnerability to
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  professional,
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  social
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  issues, emotional issues,
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  increased substance abuse, for example.
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  So it is really critical to make sure
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  you have the right provider
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  at the right time
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  intervening as early as possible.
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  So
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  telehealth is such a crucial option
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  to help close that gap.
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  Yeah. Absolutely.
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  Doctor Malair, I really appreciate the overview and
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  also highlighting some of those important long term
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  consequences of not getting care at the right
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  time.
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  And I'm curious as a quick follow-up.
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  You know, you've touched on how telepsychiatry
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  is really helping to bridge those access gaps
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  and at least,
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  reduce wait times for families and children and
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  adolescents.
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  How else are you seeing,
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  you know, families and patients react to telepsychiatry?
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  Have they have has it been a favorable
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  experience for a lot of families near
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  from your perspective? Or wanted to give you
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  the chance to elaborate on any outcomes
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  on that side as well.
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  Absolutely.
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  It has been a favorable experience.
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  Sometimes, you know, people come to telehealth sessions
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  with a concern
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  about establishing
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  rapport
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  or having the same experience as they would
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  in person.
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  And for better or for worse, we've all
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  been forced to sort of have a
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  experience with virtual care during the pandemic.
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  So folks are really,
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  savvy about
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  the parameters of a telehealth appointment, you know,
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  those simple things that can get in the
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  way. How do you log on? What do
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  you expect? What's my appointment going to look
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  like?
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  Those kinds of things people are really used
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  to,
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  and especially for kids and adolescents that really
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  socialize
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  virtually as well as in person.
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  They're really used to it and have a
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  lot of skills in terms of expressing themselves
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  and joining with
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  a provider
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  via a virtual model.
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  I know families
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  appreciate the convenience
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  of not having to take the time out
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  of a busy work day or from a
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  child's activities or school
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  to travel to an appointment.
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  So it can be really more convenient
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  to have a telehealth appointment as well.
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  And when an individual has a telehealth appointment
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  in their house,
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  they are also sometimes feel a little bit
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  more comfortable,
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  about,
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  confidentiality
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  and just
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  feeling at ease during an appointment.
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  And so that's been a nice thing to
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  see.
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  It's also been really nice that our providers
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  that, are working via telehealth and assessing kids
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  and families
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  can continue to see them in follow-up appointments.
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  It's been nice that families, you know, don't
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  have that hardship of traveling, spending bus fare,
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  again, taking the time away from work or
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  school. So it does lend for
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  an ease for continuing with those follow-up appointments
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  as well.
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  Yeah. Thanks, doctor Millaire. I appreciate all these
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  points and especially what you noted,
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  just a few moments ago about,
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  you know, the the youngest generations right now,
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  telehealth and virtual care, it won't seem like
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  such a separate entity to them.
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  You know, as they're growing up, this is
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  the norm.
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  So it'll be fascinating to see how that
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  generation really interacts with care going forward.
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  So, again, appreciate you highlighting some of these
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  benefits of telepsychiatry.
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  And I know we our our time together
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  is limited, so I wanted to make sure
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  to get some of your final thoughts on
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  what you see ahead.
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  So, you know, when it comes to opportunities
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  to improve how ADHD care is delivered,
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  especially when it comes to families navigating more
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  complex or uncertain cases,
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  what opportunities are you seeing and what's on
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  the horizon from your point of view?
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  Yeah. Absolutely. I think on the horizon,
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  ongoing initiatives to continue to improve access to
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  care,
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  continuing to enhance virtual pathways,
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  that can be just lifelines,
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  for patient and families who can't find specialty
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  providers. I think the key is, again, finding
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  the specialty provider
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  that can do the right assessment
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  to start the correct treatment plan for the
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  family and patient, I think, is absolutely crucial.
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  As part of my
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  job as medical director of physician services at
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  IRIS Telehealth,
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  I've just been humbled to share that mission
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  of working to
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  improve access
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  via virtual care for the behavioral health needs
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  of various communities. So I think
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  continuing to have conversations like this,
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  to discuss
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  what options are available and how care is
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  delivered is is so important,
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  because I think organizations
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  have been really struggling
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  to make sure that they can meet the
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  needs of their community.
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  Absolutely.
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  Well, doctor Millaire, this has been such an
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  insightful conversation. I know we've touched on
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  access. We've touched on long term consequences of
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  not getting the right treatment at the right
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  time, and we've also touched on efficiency
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  and how telepsychiatry can really help with some
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  of those aims to, you know, making the
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  right diagnosis, getting folks to treatment as soon
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  as possible.
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  Just wanna make give you the opportunity to
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  share any other final thoughts or perhaps something
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  that we smoothed over too quickly.
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  Any final thoughts from your perspective?
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  Yeah. I think my final thoughts, I just
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  really, again, wanted to thank you on shedding
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  light. I think the stigma of behavioral health
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  sometimes
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  continues to to have people be a little
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  hesitant to step forward to care,
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  or the concern that it's hard to find
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  providers
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  can make it a barrier for folks to
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  step forward for care. And I think
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  consistent with ADHD,
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  chronic
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  behavioral health needs that are left untreated
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  can have chronic effects on childhood development
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  that last into adulthood.
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  So I think continuing
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  to chip away at access to care
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  and continuing to think about creatively
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  how to
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  narrow that gap in access to care
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  is something that
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  we all need to continue to give good
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  focus on.
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  Such a an excellent closing thought. Doctor Malair,
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  thank you so much again for joining the
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  podcast and for giving us your time and
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  your insights today.
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  Oh, thank you. It's been a pleasure. Thank
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  you so much for this conversation.
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  Absolutely.
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  And we'd also like to thank the sponsor
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  for today's episode, Iris Telehealth.
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  So listeners, be sure to tune into more
• 13:39
  podcasts from Becker's Healthcare by visiting our podcast
• 13:42
  page at beckershospitalreview.com.