•  Cultural and Community Considerations in Conducting Telepsychiatry with Youth
•  Roberto Montenegro, M.D., Ph.D., and Lloyda Broomes Williamson, M.D., DFAPA, DFAACAP

• Child and adolescent psychiatrists’ increased reach through the use of telepsychiatry allows youth and families of diverse backgrounds to receive services not otherwise available to them.
• Telepsychiatrists should not assume that a difference in social, economic, income, geographic, racial, ethnic or cultural backgrounds with their patients precludes ability to establish rapport and a therapeutic relationship through videoconferencing.
• Discordant beliefs between the youth and care takers are frequently related to family distress, rather than related to the family's location, ethnicity, cultural heritage, or religious affiliation. The telepsychiatrist should not stereotype but specifically inquire about the individual views of both the youth and family.
• Establishing social, political, and cultural awareness and competence with both the youth and family through videoconference requires the psychiatrist to take extra care to convey understanding of the youth's and family's needs.
• Telepsychiatrists are part of a local team. Establishing strong working relationships with the team can help telepsychiatrists to develop cultural and social competence and facilitate interventions. This may take more time and skill when collaborating through videoconferencing. The investment will yield benefits for the psychiatrist, team members, youth, family, and community.

References

1. American Academy of Child and Adolescent Psychiatry Committee on Telepsychiatry and the Committee on Quality Issues. Clinical update for telepsychiatry with children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. 2017;56(10):875–893.
2. George S, Hamilton A, Baker RS. How do low-income urban African Americans and Latinos feel about telemedicine? A diffusion of innovation analysis. International Journal of Telemedicine and Applications-Special Issue on Usability of Telehealth Technologies. 2012; Article ID 715194, 9 pages; http://dx.doi.org/10.1155/2012/715194
3. Ebaugh, Helen Rose, and Mary Curry. Fictive kin as social capital in new immigrant communities. Sociological Perspectives. 2000; 43, no. 2:189-209.
4. Brooks E, Spargo G, Yellowlees PM et al. Integrating culturally appropriate care into telemental health practice. In: K. Myers and CL. Turvey, Telemental Health: Clinical, Technical, and Administrative Foundations for Evidence-based Practice. Elsevier Insights, Watham MA, 2013; pages 63-80.