Psychiatric Assessment in this Covid 19 World

Psychiatric Assessment in this Covid 19 World

March 27, 2020

Most of us have had little experience of doing interviews remotely. The present situation is potentially dangerous for us, our staff and the claimants. Despite distancing, hygiene, warnings about not coming if unwell nevertheless, there is a risk. Fortunately we work in an area of medicine where hands-on assessment is not required.

Last week I made the decision for my safety, the safety of my staff and the claimants to do interviews remotely. The obvious choices are Skype, Zoom and even Covius, the latter two require a subscription. Zoom is free for 40 minutes. We have worked hard to encourage claimants to participate in remote interviews. The drawbacks for some claimants have been lack of access to a PC, their PC does not have a camera, patchy Internet access, fear about using technology and, surprisingly, some not only do not have a computer but do not have a mobile phone.

There was a recent article about Zoom in the Australian Financial Review:

The Trouble with Zoom

Zoom has suffered from several critical security vulnerabilities, ranging from allowing hackers into private calls uninvited, to allowing Mac users to be forced into calls without their knowledge. While such vulnerabilities were patched, Zoom’s approach to these concerns has been rather blase. In the latter case especially, Zoom essentially refused to change fundamentally flawed security practices.

Given the sensitivity of the data Zoom handles such an attitude doesn’t inspire too much confidence.

 Far from simply providing a meeting platform, Zoom actively collects large amounts of data in order to analyse its own service, and to provide business customers with some powerful features and tools that may be easily abused. These include video and audio recordings, audio-to-text transcriptions, detailed network information, advertising IDs and even detailed and intrusive monitoring of what is on the screen of meeting attendees.

 Zoom’s collection of much of this information without first seeking the consent of attendees, or properly informing them of what information is being recorded just increases these concerns.

 From potential clashes with the protections against unfair terms in Australian Consumer Law, to the vague and fragmented privacy policy, Zoom’s obligations to its users’ data security are few and far between.

 The Zoom privacy policy outlines a capacity for the platform to capture both data that a user freely provides (such as sign-up information), as well as “passive” information (such as data captured by cookies). Indeed, the policy makes clear that simply by using the service Zoom may collect your credit card info, employer, job title and physical address “Whether you have Zoom account or not”.

 By collecting such data without engaging its users, or indeed notifying those who use it without signing up, Zoom destroys any chance of consent and individual control over personal information.


For claimants with only a mobile phone there is FaceTime for iPhones or its equivalent Duo for Android phones (it works with iPhones too).. FaceTime cannot be used with a PC but I can use it with my iPad. People feel more comfortable using their phone. I have downloaded Google Duo on my iPhone and iPad so I can communicate with people using an android phone or tablet. This seems to work well.


My general impression is that most people find it much easier to use FaceTime or Duo rather than using Skype, Zoom and so forth.


The procedure we have developed has been:


Contact claimants days before the scheduled interview to participate in a remote interview. Give options: Skype/FaceTime/WhatsApp and talk through any issues.

Send information sheet:

Reasons for video interview

Procedure for connecting

(what to do if there is a problem)

Interview procedures

approximate time of interview (about 2 hours)

be available shortly before the interview time in case you need to be notified of any delays

allow for a delay so free up at least 3 hours

toilet before the time

have water and tissues

talk in quiet area, preferably away from others

record your weight and height

have available your documentation

medical reports

current treatment including:

names and location of treaters

type and frequency of treatment

medication list including names and dosage

If using a mobile phone keep it on charge.


After two weeks of using video technology I have found that the easiest procedure is using FaceTime (Duo with an android phone). On several occasions the Skype connection has been inadequate and we have resorted to using FaceTime. I have been using FaceTime on my iPad and this works well. In some ways the interview has been easier as claimants appear more relaxed in their own home. There is also an intimacy that develops because we’re talking face-to-face and this facilitates the interview process.


I am giving serious thought to continuing to do remote interviews especially for people living in the country or interstate when this current crisis is over.


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