The Importance of Safety in Telepsychiatry: Navigating Mental Health Care from Home

The rapid expansion of telehealth in mental health care, particularly in psychiatry, offers unprecedented accessibility. However, it also presents novel safety and ethical challenges (Stoll et al., 2020). While the convenience of a virtual appointment is celebrated, a dangerous trend is emerging: patients attempting to conduct deep, often vulnerable psychiatry sessions while actively driving—sometimes with small children in the back seat.

The pressure to "fit it all in" is understandable. But the moment the car is moving, the professional, legal, and ethical foundation of our session is compromised. As your psychiatric provider, I must enforce a hard stop: if the wheels are turning, the session must be paused or terminated. This requirement is mandated by the professional standard of care, which does not change based on the technology used (Lynn, 2020).

1. The Safety and Quality Mandates

The consensus among healthcare bodies is that a telehealth session requires a private, secure, and stationary environment to ensure safety and quality (Ibrigimov et al., 2022).

• Violation of Standard of Care: A psychiatric session demands intense cognitive and emotional focus. Discussing sensitive issues, such as trauma or medication changes, while navigating traffic constitutes severe distracted driving and fundamentally fails to meet the accepted standard of practice (Hardy et al., 2020). Continuing the session places the patient, the provider, and the public at an unacceptable risk of harm.

• Impaired Clinical Utility: The effectiveness of telepsychiatry is dependent on the therapeutic alliance and the accurate assessment of symptoms (Gentry et al., 2019). When a patient is distracted by driving, they cannot engage fully. This distraction can lead to potential miscommunication, misunderstanding of treatment plans, and a diminished ability for the provider to conduct a thorough mental status examination.

  
  

• Confidentiality Breach: Conducting a sensitive medical appointment in a moving vehicle violates the security requirements of the Health Insurance Portability and Accountability Act (HIPAA). Confidentiality is instantly compromised if the session is overheard by passengers or passersby (Goldschmidt et al., 2021).

  
  

2. Legal Precedent and Florida Regulatory Risk

While telehealth generally adheres to the same standard of care as in-person visits, the unique risks of remote care, particularly related to location and emergency response, create specific legal liability for the provider (Wapner Newman, 2025).

Case Law & Telehealth Malpractice

Currently, there are no widespread, published judicial opinions explicitly detailing a patient suing a psychiatrist after a car accident that occurred while on a telemental health call. However, the legal consensus is clear:

• The Same Standard Applies: Malpractice cases in telehealth are adjudicated based on the principle that the provider's duty of care is the same online as it is in person (Wapner Newman, 2025).

  
  

• Proximate Cause: If a provider is aware a patient is driving, and they fail to terminate the session, a strong argument for negligence can be made. If that negligence (failure to enforce a safe setting) is found to be the proximate cause of the patient's injury (the car accident), the provider may be held liable. The scarcity of public case reports is more likely due to settlements or the cases still being in litigation, not an absence of liability.

  
  

Florida Specific Law

• Florida Statute mandates that a telehealth provider must practice in a manner consistent with the "prevailing professional standard of practice" for in-person care (Florida Senate, 2024). A driving patient environment clearly falls below this minimum standard.

  
  

• Emergency Protocol Failure: Florida law requires documentation of the health care services rendered. For safety and compliance, providers must know the patient's stationary physical location to execute a crisis plan (i.e., sending emergency services). A moving vehicle renders any emergency plan useless, constituting a direct failure of a provider’s ethical and legal safety obligation (Ibrigimov et al., 2022).

  
  

3. Solutions for Finding Your Private Space 🧘‍♀️

The challenge of finding privacy should not lead to taking dangerous risks. Safe telehealth demands planning. Please aim for a parked, private, and secure location for every session. Finding a good spot requires creativity:

• Your Parked Car: Your vehicle offers great physical separation and sound dampening. It is a secure, single-occupancy space, provided it is legally and safely parked for the full duration of the session. Using headphones or earbuds is essential here for maximum privacy.

  
  

• Quiet Rooms at Home: Consider the smallest, quietest, and most sound-isolated rooms, such as a walk-in closet or laundry room. These spaces create a clear boundary. Post a note on the door for security and use a sturdy box or chair for comfort.

  
  

• Public Library: Many public libraries offer small, reservable study carrels or private rooms for free. These provide quiet, reserved space. Be sure to check their Wi-Fi security and bring noise-canceling headphones.

  
  

Your mental well-being is worth 45 minutes of dedicated, safe, and private attention.

4. The Role of Technology in Telepsychiatry

In today’s digital age, technology plays a crucial role in telepsychiatry. It enhances accessibility and convenience, allowing patients to connect with their providers from the comfort of their homes. However, it is essential to use this technology wisely.

Choosing the Right Platform

Selecting a secure and reliable telehealth platform is vital. Look for platforms that comply with HIPAA regulations to ensure your information remains confidential. A good platform will also offer features like video conferencing, messaging, and appointment scheduling.

Preparing for Your Session

Before your telepsychiatry session, take a moment to prepare. Find a quiet space where you won’t be interrupted. Test your technology to ensure everything works smoothly. This preparation helps create a conducive environment for effective communication.

5. The Importance of Communication

Effective communication is the cornerstone of any therapeutic relationship. In telepsychiatry, it becomes even more critical.

Expressing Your Needs

Don’t hesitate to express your needs during the session. If you’re uncomfortable or distracted, let your provider know. Open communication fosters a trusting relationship and enhances the overall effectiveness of the therapy.

Feedback and Follow-Up

After your session, provide feedback to your provider. This feedback helps them understand your experience and make necessary adjustments for future sessions. Follow-up communication is essential for continuity of care.

Conclusion

Telepsychiatry offers a valuable resource for mental health care, but it comes with responsibilities. Prioritizing safety and confidentiality is crucial for effective treatment. By finding a secure space and using technology wisely, we can ensure that our sessions are productive and beneficial.

Your mental health is important, and I am here to support you on your journey. Together, we can navigate the challenges of telepsychiatry and work towards your wellness goals.

References

Florida Senate. (2024). Chapter 456, Section 47: Standards of Practice for Telehealth. Retrieved from https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0456/Sections/0456.47.html.

Gentry, M. T., Klemanski, D. H., & Morris, M. A. (2019). Telehealth interventions for anxiety disorders: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 25(3), 125–134.

Goldschmidt, D., Rhee, B., & Gonsalves, D. (2021). Mental health care during the COVID-19 pandemic: Implications for patients, clinicians, and the therapeutic alliance. Counselling and Psychotherapy Research, 21(1), 17–28.

Hardy, S. A., Tynan, T., & Voth, R. (2020). Digital boundaries: A review of clinical and ethical issues in telepsychology among mental health professionals. Ethics & Behavior, 30(6), 469–484.

Ibrigimov, I., Al-Ali, S., Al-Jazairi, M., & Al-Tawil, M. (2022). Ethical issues in telepsychiatry: A systematic review. International Journal of Social Psychiatry, 68(3), 643–652.

Lynn, J. (2020). Telemental health: Mitigating the practitioner’s risk. The Journal of Legal Medicine, 41(2), 171–190.

Stoll, J., Sadler, J. Z., & Trachsel, M. (2020). The ethical use of telepsychiatry in the COVID-19 pandemic. Frontiers in Psychiatry, 11, 665.

Wapner Newman. (2025). Telemedicine risks: When does virtual care become malpractice? Blog Post]. Retrieved from [https://www.wapnernewman.com/the-risks-of-telemedicine-can-virtual-care-lead-to-malpractice/.