Best Practices for Telehealth Mental Health Assessments

Remote mental health assessment is not just "in-person but on a screen". It is a different skill.

You need different tools. Different questions. Different safety plans.

This blog gives you 12 best practices. Use them as a checklist. Tick them off one by one. Your remote sessions will improve immediately.

Best Practice 1: Use Secure Platforms Only

Do not use FaceTime, regular Zoom, or Skype. These are not secure enough for healthcare.

What to use instead:

• Doxy.me (free for basic use)

• Zoom for Healthcare (paid, HIPAA compliant)

• VSee

• Your organisation’s approved platform

Check before every session: Encryption is on. You are not recording without consent. The platform does not store data in unapproved locations.

Best Practice 2: Have a Pre-Session Checklist

Send this checklist to patients before their first remote session:

• Find a private room with a door

• Use headphones if others are home

• Make sure your camera and microphone work

• Charge your device fully

• Have a backup phone nearby

• Remove dangerous objects from the room

• Write down emergency numbers

This saves time and prevents problems.

Best Practice 3: Start With a Environment Check

At the beginning of every session, ask the patient to show you their room.

Look for:

• Other people (should leave)

• Sharp objects or medications (should move)

• Adequate lighting (can you see their face?)

• Background (is anything concerning?)

Document what you see.

Best Practice 4: Set Clear Remote Boundaries

Remote work blurs lines. You need stronger boundaries.

Set these rules:

• Sessions start and end on time

• Patients must be dressed appropriately (not in bed)

• No eating during sessions

• No driving during sessions (pull over first)

• If the connection fails, wait 5 minutes then call

Tell patients these rules at the first session. Repeat them as needed.

Best Practice 5: Adapt Your Questioning Style

Remote sessions need different questions.

Instead of "Show me how you are feeling", ask "Describe how your body feels right now"

Instead of "Take a deep breath with me", say "Take three slow breaths on your own"

Instead of "Look at me", say "Look into the camera when you speak"

Think about what you cannot see. Ask for descriptions.

Best Practice 6: Use the "Two Feet" Rule for Risk

In person, you can see if a patient is restless. Legs shaking. Feet tapping.

On video, you cannot. So ask:

• "Are your feet tapping right now?"

• "Do you feel like you cannot sit still?"

• "Is your body feeling calm or agitated?"

Patients will tell you if you ask.

Best Practice 7: Document Your Remote Setup

Good documentation protects you. Include remote-specific details:

• Platform used (e.g., Doxy.me, version number)

• That you checked patient privacy

• Any technical issues and how you resolved them

• That you confirmed the patient’s location

• Emergency contact information on file

This is especially important for high-risk patients.

Best Practice 8: Create a Remote Crisis Card

Give every patient a small card (digital or printable) with:

• Your contact info (for scheduling, not crisis)

• Local crisis line number

• National suicide prevention line

• Emergency number (911, 999, 000, or local)

• Their safety plan summary (2-3 bullet points)

Update this card whenever the safety plan changes.

Best Practice 9: Use the "Three Question" Safety Check

Ask these three questions at the start of every session:

1. "Do you feel safe right now where you are?"

2. "Has anything happened since we last spoke that I should know about?"

3. "Are you having any thoughts of harming yourself or others?"

Do not skip this. Even for low-risk patients.

Best Practice 10: Know Your Local Emergency Resources

You cannot help a patient in crisis if you do not know who to call.

Keep a list for each area you serve:

• Mobile crisis team number

• Local emergency room psychiatric intake

• Non-emergency police number

• Crisis respite house (if available)

• 24-hour pharmacy (for medication emergencies)

Update this list every 6 months. Numbers change.

Best Practice 11: Take Care of Your Own Setup

You ask patients to prepare. You must prepare too.

Your setup checklist:

• Camera at eye level (not looking down)

• Good lighting from the front

• Neutral background (no personal photos or mess)

• Comfortable chair with back support

• Water bottle nearby

• No phone notifications during sessions

Your professional appearance matters. It builds trust.

Best Practice 12: Schedule a Technology Backup

Plan for failure before it happens.

Your backup plan:

• If video fails, switch to phone

• If phone fails, ask patient to restart device and call back in 3 minutes

• If still fails, reschedule within 24 hours

• For crisis patients, emergency services are your backup

Write this plan down. Keep it next to your computer.

Putting It All Together

You do not need to do all 12 practices perfectly on day one. Start with the first 3:

1. Use a secure platform

2. Send the pre-session checklist

3. Start with an environment check

Add one new practice each week. After 12 weeks, you will have a complete remote assessment system.

Learn More in Our Course

Our Remote Mental Health Risk Assessment CPD course includes video demonstrations of all 12 best practices. You get printable checklists, sample forms, and a certificate.

Frequently Asked Questions

Q: Can I use the same assessment forms remotely?
Yes, but adapt them. Add remote-specific questions. Remove questions that require physical observation.

Q: How long should a remote assessment take?
Similar to in-person. 45–60 minutes for initial assessment. 20–30 minutes for follow-up. Shorter sessions work better online.

Q: What if the patient wants to record the session?
Policies vary. Some organisations allow it with written consent. Others do not. Check your local rules. Document any agreement.

Q: Do I need written consent for remote sessions?
Yes. Get signed informed consent for telehealth. Explain the risks (tech failure, privacy limits). Keep the form in their file.