Text messaging can offer a convenient and widely accessible mode of communication, enabling communication and support when patients need it. In mental health support, this can be useful for mental health practitioners to offer their patients. However, when protected health information (PHI) is transmitted, HIPAA compliance is necessary.
Text messaging as a tool
Text messaging is a valuable tool for providing individuals with mental health support, including emotional support. It allows for ongoing communication between mental health professionals and their clients. Text messaging can offer timely responses and validation, helping individuals navigate their mental health challenges between therapy sessions.
It also facilitates the delivery of educational information and resources to empower individuals to manage their mental well-being. The accessibility and convenience of text messaging make it an effective means of providing emotional support in a personalized and responsive manner.
Related: The physical safeguards for mental health practice HIPAA compliance
Uses of text messaging
- Appointment reminders
- Emotional support
- Psychoeducation
- Medication reminders
- Crisis intervention
- Support groups
- Behavioral monitoring
- Coping skills training
- Self-reflection and journaling
- Peer support
HIPAA compliance and text messaging
When selecting a text messaging service for mental health purposes where PHI may be shared, practitioners must choose a service that explicitly states its HIPAA compliance. Additionally, look for a service that offers secure data transmission through encryption and access controls to ensure that only authorized individuals can access patient data. A text messaging service with audit logging capabilities allows for monitoring and identifying potential security breaches. Selecting a service that provides a signed business associate agreement (BAA) to ensure compliance with HIPAA's Privacy Rule is also necessary.
Related: The guide to HIPAA compliant text messaging
Measures to ensure HIPAA compliant text messaging
Obtain informed consent
Before text messaging with a patient, obtain written informed consent explicitly stating their understanding and acceptance of the potential risks and benefits of electronic communication.
Minimize PHI in messages
When sending text messages, avoid including unnecessary or sensitive patient information. Minimize the use of patient identifiers (e.g., full name, date of birth) and limit discussions of clinical details to what is necessary for therapeutic purposes.
Educate patients on privacy risks
Inform patients about the potential privacy risks associated with text messaging, including the possibility of unintended disclosure if their device is lost or stolen, or if they share their device with others.
Set expectations and boundaries
Establish clear guidelines and boundaries with patients regarding the use of text messaging for therapy or counseling.
Regularly review consent
Periodically review and update the patient's consent for text messaging. Confirm that the patient still agrees to communicate via text messages and understands the associated risks and benefits.
Document communication
Maintain accurate and thorough documentation of all text message exchanges with patients, including date, time, and a summary of the content discussed.
Limitations on text messaging
Text messaging poses inherent security risks, such as the potential for unauthorized access, interception, or unintended disclosure of messages. Its use may result in delayed responses due to various factors such as time zone differences, technical issues, or other commitments. Text messaging also lacks non-verbal cues such as tone of voice, facial expressions, and body language.
Text messaging has limitations in the amount and complexity of information that can be conveyed. It may not be suitable for discussing in-depth or sensitive topics, which should be done over other methods of communication, such as HIPAA compliant email. Lastly, not all patients may have access to reliable internet or mobile connectivity, or they may have limited proficiency with texting or smartphone technology.
Related: Email marketing for therapists
Kirsten Peremore
