Utilizing a Medical transcription company is a standard in the healthcare industry for physicians of all kinds, and it got an even more considerable boost during the COVID quarantines and lockdowns. Mental health transcription, however, is a different matter altogether and requires an expert to get the job done. Psychiatrists, psychologists, and other mental health professionals provide essential medical services to patients, but their processes and requirements differ widely from your usual physician.
Often, there are no templated clinical notes. Discussions go longer than the usual doctor-patient diagnoses duration, and the stakes are — despite detractors claiming otherwise — just as high as usual healthcare and emergency care practices. Therefore, medical transcription service providers handling mental health professionals must be experts in their field.
In this article, we’ll outline the differences between physical and mental healthcare and why your choice of transcription provider matters.
Differences in Diagnostic Processes
Try to recall your last visit to the doctor for some physical ailment. The interview is your typical fare: what seems to be the problem, how do you feel, how painful is it, what seems to be triggering it, and other common questions are asked. These questions are quickly answered, and the doctor can (in usual instances) diagnose your problem or at least order the most appropriate tests to get to the root of things.
Runny nose, cough, and fever? Probably a viral cold, but we better run other tests. Fell and got your ankle twisted? Better get that X-rayed just to be sure. Established practices like cardiology or internal medicine also have a lot of phrases and terms that can be used to standardize their note-taking and transcription process.
Now, I don’t want to generalize, and I understand that healthcare is a nuanced profession that requires a lot of time and effort to perform correctly. I am also not belittling the work of physical health professionals — they work on and with the human body’s complexities, which is something not everyone can do, much less fathom. The point that I’m driving at here is that the processes of diagnoses for physical and mental health are very different.
The Stigma in Mental Health Cases
In mental health cases, patients often carry the stigma of their conditions. Sometimes, they’re not even sure if they are suffering from a mental health condition. Sometimes, they don’t have the willingness or capability to express their issues with the doctor, a problem that is not as widespread as in physical healthcare. This makes the diagnostic process longer, producing longer recordings and longer transcripts.
The talks may cover days to weeks of emotions, actions, and events. Feelings can run high, information can come in torrents or drops, and the mental healthcare provider has no idea which piece of detail being given will lead to the successful diagnosis of the patient, so everything needs to be noted.
This difference in diagnostic strategy is reflected in the transcription side of the process. Mental health transcriptionists must listen to longer recordings, sometimes an hour or more, transcribe many details, and get everything right. Standard medical terms may not apply as doctors describe their conditions because every case is unique. This leads us to our next topic: accuracy.
Accuracy in Mental Health Transcription
The beauty of standardized medical terminology is that it can make the work of doctors, nurses, related healthcare professionals, and even transcriptionists easier. Anybody in the medical field hearing CBC, ECG, or GSC, or seeing Dx, imp., or incr. on a doctor’s note immediately knows what the person is referring to. This prior knowledge or familiarity increases accuracy when reading or transcribing medical documents.
For mental health professionals, however, these terms may have limited utility. Furthermore, documents and recordings will vary from patient to patient. Words used to describe a particular feeling in one recording may not be used in a different one despite the patients describing the same thing. Inexperienced transcriptionists may have difficulty with varying degrees and interpretations — because there is no standard way of conveying mental health issues and emotions.
Offshore vs. Local Transcription
The difficulty presented by mental health transcription may magnify some issues in the different types of transcription services. For example, offshore transcription services hire foreign transcribers who may not have the same grasp of the English language as a native speaker. The sensitive and non-standard nature of mental health recordings may increase error rates as foreign transcriptionists encounter words or phrases that are not commonly used in other healthcare fields.
In our experience, mistakes occur with a foreign company, significantly more so in behavioral health transcription. Providers often use slang words or phrases that aren’t as common or well-known in other countries. This makes it hard for a foreign transcription company, even one with a QA supervisor, to get accurate transcription for mental health evaluations.
Their notes often include American slang or words non-native English speakers might need help understanding. Whereas specialties like surgery or cardiology often use standard or canned phrases for their notes because underlying conditions, techniques, surgeries, etc., often are similar if not identical. Mental health professional’s notes run the gamut of everything they discussed with the patient, which varies widely with each case.
In addition, it is not enough just to choose a U.S.-based transcription company.It is also essential to choose a company that has experience specifically with the mental health industry. Because these narratives vary significantly from other kinds of medical transcription yet still include medical terms, medication notes, and other items only a trained medical transcriptionist would know. The best accuracy comes from a company with experience transcribing these more unique medical notes.
Security and Confidentiality
Objectively, every piece of a patient’s private medical file should be treated with the same level of security and confidentiality as any other. All medical reports or notes have sensitive, personally identifiable information (PII) attached that must be kept confidential.
Subjectively, however, mental health records can be much more sensitive than other types of medical records. The world has come far in acknowledging mental health issues as legitimate medical concerns that impact a patient’s mental and physiological state, but that doesn’t mean the stigma isn’t there. Patients may be discriminated against if undisclosed mental health information is made public without consent. Sufferers may be discouraged from seeking the help they require because of the threat of judgment.
Therefore, any mental health practice must ensure its transcription provider has the safeguards to maintain doctor-patient confidentiality and encourage patient trust. Most transcription providers offer security through non-disclosure agreements (NDAs), secure servers, encrypted file transfers, and VPN use.
Some companies cut the recordings into multiple smaller sections so that every transcriber will only ever get to work on a single part of a larger file. Unfortunately, this isn’t a great security measure; some transcribers will still have access to patient information. All this accomplishes is creating unnecessary segmentation of work, which can lead to increased error rates.
The highest security level a mental health transcription company can achieve is the Health Insurance Portability and Accountability Act (HIPAA) Compliance. This ensures the company meets every part of the HIPAA security requirements, minimizing patient information breaches.
The Hidden Toll of Mental Health Practice and Transcription
Psychologists and other mental health professionals may have decades of experience handling cases related to their field, but they’re human, too. It’s common for mental health patients to have experienced sexual and physical assault, neglect and abuse, combat-related issues, witnessing violent deaths, and other traumatic activities. It can be difficult to hear what horrific things other people have gone through, and it can negatively impact healthcare professionals — and transcriptionists, too.
This type of emotional duress is called secondary traumatic stress (STS, also known as vicarious traumatization, compassion fatigue, and critical incident stress). While primary trauma directly impacts the individuals who experience a traumatic event, secondary trauma affects those who witness or hear about the trauma experienced by others. The emotional toll of absorbing and empathizing with others’ traumatic experiences can lead to symptoms similar to those experienced by individuals who have directly experienced trauma. Even with awareness, it can be difficult to be sure if a person is experiencing secondary traumatic stress, especially in the context of work burnout. And even if the individual knows that they are suffering from STS, it can be difficult to admit that they need help.
Transcription companies must be aware of STS and its impact on their employees. Effective management, supervisor and peer support, mental health breaks, and awareness advocacy are ways providers can support their mental health service transcriptionists.
Ditto Transcripts is a Denver, Colorado-based mental health transcription services company that provides fast, accurate and affordable transcription services for hospitals, clinics, facilities and individual practices of all sizes. Call (720) 287-3710 today for a free quote, and ask about our free five-day trial.