Telepsychiatry, especially in the form of live interactive videoconferencing, has greatly advanced the availability and use of specialist psychiatric consultations in primary care settings. Nevertheless, reliance on telepsychiatry, with corresponding decreases in direct face-to-face interaction between primary care providers and psychiatrists, can create unique challenges such as reducing the availability of non-verbal cues, and preventing the informal interactions that are so necessary for clarifying clinical and process details and for building essential team-based trust and rapport. Written from the perspective of an integrated psychiatrist, this article offers recommendations for a formal process to optimize virtual care coordination by setting clear expectations and providing communication tools for an effective and efficient telepsychiatry enabled integrated service.

Most suicides occur among adults of working age and workplace suicide prevention is a public health priority. Workplace suicide prevention efforts, however, remain limited. This paper describes and evaluates a workplace-based suicide prevention gatekeeper training delivered in-person and virtually. VitalCog is a 2-h suicide prevention program designed specifically for the workplace and based on best practices for gatekeeper training. It is designed to be practical and interactive, with four modules (why prevention matters, what to do if someone is suicidal, conversations about suicide, and postvention), each containing related video, group discussion, and role play exercise components. It was delivered live by experienced trainers either in-person or using synchronous technologies between 2018 and 2021. A mixed methods pre- and post-training design with no control group was used to evaluate in-person vs. virtual delivery to determine knowledge gain, confidence identifying warning signs, and comfort levels talking about suicide. One thousand two-hundred and forty-four (1244) pre- and post-training responses were analyzed, with no significant ( p > .05) socio-economic differences between the pre-training and post-training respondent samples. Both in-person ( n = 841) and virtual ( n = 403) training groups demonstrated statistically significant increases in knowledge about suicide prevention and seeking help, confidence to identify suicide warning signs, and comfort levels talking to someone about getting help. Interestingly, the virtual group showed higher post-training outcome scores than the in-person group. While COVID-19 significantly reduced in-person training opportunities, these results suggest that offering VitalCog virtually is as effective as in-person, and potentially has advantages over in-person training.

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