The Use of Videoconferencing in Forensic Evaluations: Moving Forward in Times of COVID-19

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that leads to the disease COVID-19, has resulted in significant challenges for the medical and psychiatric communities. Much like other clinicians during this global pandemic, forensic evaluators have been faced with the difficult task of continuing their clinical work, while helping to maintain the safety of their examinees, support staff, correctional personnel, and themselves. As such, the implementation of telehealth appears to be a viable alternative to in-person evaluations, but questions regarding the fidelity of these forensic evaluations remain at the forefront. The goal of this paper is to examine data relevant to conducting forensic evaluations using telehealth platforms. We offer both pros and cons of using telehealth videoconferencing to conduct forensic evaluations, so that the forensic evaluator may make an informed decision regarding whether they plan to utilize this technology. Additionally, we discuss considerations for training in the delivery of telehealth services. This paper concludes with a discussion of areas for future research, such as the examination of modifications practitioners have made to their practice and the reliability of forensic opinions conducted over telehealth. We end by suggesting telehealth is the path forward for forensic evaluation, regardless of public health status.

Forensic practitioners’ use and perceptions of telepsychology before and during COVID-19.

“…Consistent with prior telepsychology-use studies (e.g., Backhaus et al, 2012;Batastini et al, 2020;Hilty et al, 2013), the present study's before-COVID-19 respondents reported that their primary motivation for using telepsychology related to the ability to access clients in remote areas. The primary motivation among forensic practitioners during COVID-19 shifted to the safety and health of the evaluator (82%), supporting recent researchers' consideration of this as an important reason to use telepsychology in forensic practice (Mulay et al, 2021). Training in the use of telepsychology techniques increased threefold during COVID-19, mainly through conferences and outside workshops unattached to training programs or the workplace.…”

A qualitative study exploring the experiences of multi-disciplinary staffs in a medium secure service when working from home and virtually during the COVID-19 pandemic

“…While the wider literature often promotes the efficacy and satisfaction of telemedicine and virtual consultations among normal, community populations (Healy et al, 2018), the current findings suggest that this working practice is somewhat harder in secure psychiatric settings, in part, due to the nature and complexity of patients' presentation and needs. For example, many staffs' voiced concerns about initiating and maintaining meaningful working relationships with patients via virtual platforms, a finding that aligns itself to the work of several previous authors (Cowan et al, 2019;Mulay et al, 2021). However, alternative obstacles to virtual consultations reported by staffs emerged from technological difficulties, which were considered to undermine rapport building with patients as well as generally making their roles and duties harder to perform (Bastastini et al, 2021).…”

“…However, while difficulties with technology were often raised, a perceived benefit reported by staffs concerned how virtual working actually supported long-distance admission and gatekeeping assessments alongside allowing external stakeholders to more readily attend patient care and treatment planning meetings. While undoubtedly clinically important, this finding suggests that virtual consultations perhaps supported a more efficient admission and discharge process to be achieved by the service during the pandemic as well as providing economic cost savings with less travel required for long-distance assessments (Mulay et al , 2021).…”

“…However, other studies by Batastini et al (2021) have revealed that although forensic practitioners recognized the potential benefits of video conferencing, they also raised concerns linked to technical issues that could make their roles and duties harder to perform. Similarly, Mulay et al (2021) concluded that while there are many possible reasons for using video consultation in forensic settings, including economic costs and ability to adapt interventions to suit patients, there remain concerns among professionals about using such methods with patients with paranoid illnesses due to the various technical difficulties experienced. Finally, a survey by Bernhard et al (2021) aiming to explore the perceived advantages and disadvantages of telepsychology among forensic practitioners during the COVID-19 pandemic showed that benefits were thought to include: accessibility (i.e.…”

On developing a child custody practice.

“…Due to the recent COVID-19 pandemic, interest has been shown in using videoconferencing in conducting forensic evaluations (Dale & Smith, 2021; Drogin, 2020; Mulay et al, 2021). Although not specifically developed for forensic settings, the APA Guidelines for Practice of Telepsychology (APA, 2013a) provides some guidance as well.…”