Course Pediatric Disaster Behavioral Health (PDBH) Toolkit

Considerations and Recommendations for Implementing Telepsychiatry in Pediatric Disaster Settings

Telepsychiatry plays a vital role in sustaining and expanding access to mental and behavioral health care during disasters. It enables continued service delivery despite disrupted infrastructure, escalates capacity to meet heightened needs, and reaches populations with limited access, especially in rural or underserved regions.^23,24,25,26

The below information provides considerations and recommendations for implementing telepsychiatry in pediatric disaster settings. For further information on initiating a hospital-based telepsychiatry consultation program, please see Appendix - Primer on Initiating a Hospital-Based Telepsychiatry Program.

Implementation Considerations

• Build on existing resources.
  • Leverage existing federal and agency-developed tools (e.g., ASPR, SAMHSA) to avoid duplicating effort and align with national guidance.
  • Reference rapid deployment and adaptation strategies, such as those used during COVID-19, for transitioning services to virtual care.
    • Expand telehealth privileges to broaden clinical access.
    • Deploy hybrid models based on acuity, complexity, and patient preference.
    • Utilize existing electronic health records systems to incorporate and disseminate elements of psychoeducation, legal consents, and standardized clinical assessments.
    • Foster privacy and security by establishing a therapeutic virtual environment and encourage use of headphones and secure chat if patients are unable to access private space.
    • Utilize evolving remote therapeutic monitoring systems.
• Address access gaps.
  • Identify barriers for at-risk demographic groups, rural populations, youth with pre-existing or developmental conditions, and those with limited financial or communication resources.
  • Plan for variable technology access, including solutions for encrypted mobile platforms in low-resource or field settings that enable privacy and security.
• Plan for operational readiness.
  • Ensure credentialing, payment mechanisms, data privacy, and reliable connectivity are addressed prior to activation.
  • Maintain updated directories of local behavioral health services to support handoffs and continuity of care.
  • Offer provider training, equipment guidance, and troubleshooting resources in advance of emergencies.

Evidence-Based Recommendations

• Embed telepsychiatry into pediatric emergency care.
  • Implement telepsychiatry to improve therapeutic decision-making, diagnostic accuracy, and access to specialty care.
  • Improve provider safety and satisfaction through virtual consultation options.
• Utilize virtual programming to expand care options.
  • Evidence-based mental health treatments can be implemented virtually even during the acute phase of trauma response to reduce symptoms in children and adolescents as well as their caregivers through Child and Family Traumatic Stress Intervention (CFTSI) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
  • Offer virtual group therapy, education, peer support, and parent training to expand reach when in-person settings are unavailable.
  • Provide structured virtual skill-building groups as part of early and ongoing disaster response programming.
• Ensure technology and staffing preparedness.
  • Invest in secure, durable technology (e.g., encrypted tablets and platforms), supported by reliable internet infrastructure.
  • Account for the potential burden telepsychiatry places on ED nursing staff and mitigate through streamlined workflows, cross-training, and easy access to technical support.