What would you recommend for ACT consumers in rural areas who don’t have access to the internet and in some cases phones/cell phones? Especially if ACT teams don’t have the funding for iPads, phones, etc. for consumer use?

Meeting patient needs is more challenging with COVID-19, especially for patients who are less digitally connected. While video visits are the ideal was to connect now, voice calls can still be effective. There is prior research showing telephone interventions can help patients with SMI increase physical activity [1] and provide proactive support [2] that may help avoid relapse. The “The ABC’s of Proactive Telephone Support” outline how each call should offer the below elements and be done at least once per week [2].

1. Problem Solving
2. Empathy
3. Encouragement
4. Coaching
5. Prompting
6. Praise
7. Anticipatory Guidance
8. Advocating

Telephone quitlines can also be offered to patients [3] and there are also phone lines that offer free meditation and mindfulness exercises that can be useful, like 617-384-2256. Scheduling phone calls and phone activities can thus be a good way to keep offering patients with SMI care. Any phone will work and a landline is fine. Also, consider applying for the FCC COVID-19 Telehealth Program, which can offer funds to buy patients phones. If possible, you can mail patients workbooks or handouts that can be reviewed and discussed during phone visits.

REFERENCES:

1. Lee H, Kane I, Brar J, Sereika S. Telephone-delivered physical activity intervention for individuals with serious mental illness: A feasibility study. Journal of the American Psychiatric Nurses Association. 2014 Nov;20(6):389-97.
2. Hunter EF. Telephone support for persons with chronic mental illness. Home Healthcare Now. 2000 Mar 1;18(3):172-9.
3. Schroeder SA. Smoking cessation should be an integral part of serious mental illness treatment. World Psychiatry. 2016 Jun;15(2):175-6.