Telepsychiatry — structured clinical viva

Slide 1 diagnosis. A capital video roster without local emergency MOUs is incomplete service design. Effectiveness literature assumes well-designed systems; process standards require emergency planning, privacy, and documentation.[1][2][3]

Slide 2 critical incident. Unknown address during a mid-call attempt is a process failure, not merely bad luck. Identity, location, contacts, and local dispatch pathway are non-negotiable before high-risk assessment.[2][3]

Slide 3 opportunity. Adding async primary-care pathways and a care manager aligns with Yellowlees (async viability) and Fortney/SPIRIT (teleintegrated collaborative care) rather than bare telereferral alone.[4][5][6]

1. Define telepsychiatry in one sentence. Psychiatrist-delivered assessment/treatment/consultation/education via telecommunications — modality and systems tool, not a DSM diagnosis.[1]

2. Name three evidence anchors. Hilty (effectiveness/access); Shore/Mishkind (process standards); Fortney (primary-care integration / SPIRIT models).[1][2][3][4][5]

3. Tele-emergency checklist. Identity/DOB; exact address and phone; emergency contacts; local ED/police pathway; privacy; tech check; call-drop plan; who is present.[2][3]

4. Async vs sync. Yellowlees RCT supports both as clinically viable in primary care when matched to workflow — not automatic hierarchy.[6]

5. Ethics domains (Sabin-style). Consent for modality, confidentiality, competence with technology, jurisdiction/practice boundaries, emergency planning.[7]

6. Paediatric emergency tele. Organised ED/urgent telepsychiatry pathways can deliver child and adolescent crisis care when developmental MSE and safeguarding are built in.[8]

7. COVID lesson. Rapid scale possible; equity and quality not automatic.[9]

8. What not to do. Start lithium/clozapine without local monitoring logistics; claim tele alone fixes workforce shortage; assess high risk without address.[2][4]