Delivering Hope Through Technology
Business View Magazine interviews Dr. Edward Kaftarian, CEO of Orbit Health, for our focus on Innovations in Telehealth
Orbit Health is a ground-breaking organization that delivers high quality telepsychiatry services remotely via technology to facilitate mental health care. Their clients include correctional facilities, hospitals, clinics, and residential youth homes and they also have a forensic expert witness group that assists attorneys and courts in matters that involve mental health.
Underscoring the tragedy that many people who deserve mental health treatment are thrown behind bars where they are exposed to trauma and further deterioration, the Orbit Health family is committed to breaking the cycle of mass incarceration of the mentally ill by providing mental health care in communities and correctional facilities. Orbit Health is there to help people get the care they need, whether at the time of arrest, in court, behind bars, on parole, in residential youth homes, or community mental health clinics. Healthier people means a healthier society.
Business View delved into the details of this vital health care sector with Dr. Edward Kaftarian, CEO of Orbit Health and a pioneer in Correctional Telepsychiatry and founder of Cyberpsychiatry. He shares how Orbit Health is endeavoring to make a difference in ending the cycle of incarceration of the mentally ill, and the impact that will have for society, overall.
BVM: Can you share the origins of Orbit Health and the mission today?
Kaftarian: “I had a lot of experience working in executive level positions for the California Prison Systems mental health program. I noticed we were having trouble recruiting psychiatrists to rural prisons and we were having a much easier time recruiting in the Bay area of San Francisco and metropolitan areas. So, in 2009, I made a pitch to develop a statewide telepsychiatry program. After I was authorized to build that out, it became the largest correctional telepsychiatry program in the world.
“It took a few years to really gain momentum but ultimately we served almost all the prisons across the State of California. So based on that success, I started Orbit Health with a mission to help end the cycle of mass incarceration for the mentally ill – there are enough mentally ill people in jail and prison to fill the City of Cleveland, Ohio. We provide services to correctional facilities, as well as serving people that are at risk for incarceration; people with substance abuse problems, major mental illness like schizophrenia, bi-polar disorder, depression. We also provide expert witness testimony to the courts, so at every point we provide services that will help end that cycle of mass incarceration.”
BVM: Do you help young people, as well as adults?
Kaftarian: Yes. One of the areas that we’re the most proud of is that we help children and adolescents that are vulnerable to incarceration, as well as substance abuse, homelessness, and are overall at risk for having problems. Our services includes residential youth programs and STRTPs (short term residential therapeutic programs) – basically a facility that provides specialized, intense therapy and 24-hour care and supervision to children. We provide telepsychiatry services to these facilities and they’ve come to rely heavily on our help. Providing medication management for children that have significant mental health disorders is one way we’re preventing the cycle of incarceration, by treating children prior to them ending up in gangs and committing crimes that would result in them going to prison.”
BVM: What other sectors do you work with?
Kaftarian: We’re also available to help support police officers. So if they encounter a mentally ill person, they can utilize our services onsite to avoid having to arrest and incarcerate that person. I’ve had a lot of experience working in jails and I’ve noticed quite a few people with severe mental disorders like schizophrenia where they’re paranoid, they’re psychotic, maybe confused and they sort of wander into police custody. Police don’t really know what to do with them, so they take them to jail. Whereas, we assist them to direct the patient to treatment instead.
“We speak to the subject directly and coordinate with the police so they can make better decisions about how to handle the patient. And also to identify resources and places where the patient can go to get treatment, because incarceration is highly traumatic. Most mentally ill people who are incarcerated have histories of trauma, and adverse childhood experiences (ACEs) such as violence, being abused physically, sexually, or emotionally, growing up in a chaotic family environment or being in foster care. These things actually affect how the brain develops.
“So when you incarcerate somebody who already has a history of trauma, you’re making it worse. They are triggered by that, retraumatized, and it’s very damaging to their mental health. But it’s also damaging to society because those people require more and more resources, they’re sort of out of control in terms of their ability to function in society.”
BVM: What impact has COVID had on mental health issues?
Kaftarian: “I think COVID has been traumatizing to everyone. And especially early on, there was very little access to mental health professionals onsite. So it became crucial to have other means of accessing mental health care. For that reason, a lot of people went without care, so now I expect a wave of mental illness post-COVID that is going to require society to really focus on increasing resources for mental health care. We’re already seeing an increased attention on mental health and people understanding the value of mental health care. So COVID did heighten our awareness of the significant mental health problems that are happening in America. But as time goes on, statistics of substance abuse and numbers of suicides are getting worse and it’s not going away any time soon.”
BVM: What advice would you give your health professionals for their own mental wellbeing?
Kaftarian: “We’re national providers with psychiatrists and nurse practitioners in all 50 states. We also provide treatment to community mental health centers. Inpatient and outpatient units at these centers help people who have limited means; the same people who are more at risk for incarceration. And there are many of these clinics that we cover.
“I’ve been doing psychiatry for quite a long time and I always felt that the way to protect from burnout is to make sure you practice self-care. Getting good exercise, enough sleep, but that’s only one part of it. It’s also how you frame it. If you approach your patient in a way where you feel responsible for all the outcomes and all their life issues, then you will feel overwhelmed. You need to approach it as, you’re there to help… there is endless pain and suffering in this world but like any other medical provider you have to compartmentalize. You’re empathetic, you listen, you care but when the appointment is done, you need to stop thinking about the patient and move on to the next one. It’s all how you approach it.”
BVM: What role does education play in Orbit Health?
Kaftarian: “We do education through Orbit University – a division of our company that does online training for health care professionals who deal with mentally ill people, and non-health care professionals like custody staff and police officers, to get mental health sensitivity training. To make sure that when they’re encountering somebody that they’re aware of the possibility of mental health problems. And if so, that they approach them and deal with them in a sensitive manner. Also, we train them on how to de-escalate mentally ill people. Sometimes psychotic or manic people or that have any significant condition, might escalate and cause some sort of disturbance. The goal is not to make it worse by going in and using force. That’s historically how law enforcement handled mentally ill people.
“But these days, law enforcement is getting more sophisticated, in part because of the training they receive about how to deal with this by de-escalation. We assist with that, as well, but the training is a way that we advocate for it. I have given many lectures in my career to law enforcement and health care professionals on how mental illness affects behavior, and how to look objectively and rationally at how to approach these people in a helpful way.”
BVM: What would you like Orbit Health to achieve in the next three to five years?
Kaftarian, “We want to achieve a nationwide rollout of our app that will directly assist police officers in terms of helping mentally ill people on the street. That’s definitely something we’re excited about. We also want to integrate services between the community mental health centers that we serve, as well as the jails and prisons. So if an inmate is released, we want to follow them through their probation or parole and in their outpatient treatment. Then if they need to go back to jail for whatever reason, or to the hospital, the care would follow them. At Orbit Health, we are striving for a complete integration of care.”