Continuity of Care in the Epicenter of a Global Pandemic: How One New York City Rehabilitation Psychology Outpatient Service Met the Challenge of COVID-19

Abstract

To provide useful insights for future crises by describing the large-scale rapid deployment of telehealth services which provided continuity of psychological care for rehabilitation outpatients living in New York City (NYC), the epicenter of the global COIVD-19 pandemic. Case Study. Interdisciplinary general rehabilitation facility located in the heart of NYC. A large-scale rehabilitation psychology service providing individual and group psychotherapy and cognitive remediation to adult outpatients with acquired brain injury, stroke, multiple sclerosis, and other disabling health conditions. Implementation of telehealth services on an urgent basis after NYC’s “lockdown” went into effect on March 22, 2020. At this time, NYC began enforcing Matilda’s Law, which restricted travel outside the home for vulnerable individuals including those over 70 and those with chronic health conditions. Number of patient visits completed. Patient and staff satisfaction with telehealth services. After declining by over 50% as the pandemic shut down much of NYC, the number of clinical encounters rebounded to 100% of pre-COVID levels with the introduction of telehealth services. Approximately 75% of staff psychologists reported satisfaction with delivering psychological services via telehealth, including the provision of essential continued care, while addressing social isolation and other emergent mental health concerns for vulnerable rehabilitation outpatients self-quarantining in their homes. Similarly, a majority of patients reported satisfaction with the ability to continue their psychological treatment during the lockdown, while avoiding risk of exposure to the coronavirus. This case study provides useful insights for future crises that require rapid responding and change to clinical program structure in order to meet the needs of vulnerable outpatients with disabilities.