Guest blog: One size doesn’t fit all for TD patients

MHA Admin

Mon, 04/03/2023 – 15:10

by Rimal Bera, MD

Browsing through a store, boarding public transit, or sitting around a conference table may seem usual. But for patients with tardive dyskinesia (TD), everyday tasks can be more taxing – physically, mentally, and socially – than many people realize.

TD is a movement disorder that affects more than 500,000 Americans. Mental health patients on antipsychotics may develop this condition as a side effect of their medication. It typically manifests as involuntary or repetitive movements.

Diagnosis and treatment are important for maintaining and improving these patients’ quality of life. As health trends draw patients away from in-person doctor visits, there are some conditions, like TD, where clinicians must physically see a patient.

Tardive dyskinesia and telehealth

During the COVID-19 pandemic, telehealth became important for many patients. It made connecting with a provider easier, cut down on commutes, and allowed more patients to access care.

Taking a balanced approach to telehealth and evaluating a patient’s individual condition and needs is a necessary part of crafting a care plan. That’s especially true for patients with movement disorders such as tardive dyskinesia.

Those with TD may be embarrassed by the involuntary movements made in public, which could even lead to self-isolation. Without the right treatment, individuals with TD can see their quality of life suffer, and other people’s perception of them may be impacted. Identifying all symptoms and interrelated conditions is crucial to developing a treatment plan. For many patients and providers, arriving at the right diagnosis and treatment for tardive dyskinesia is more easily and effectively handled in person.

Diagnosis is in the details

A recent survey examined how clinicians feel about evaluating, diagnosing, and monitoring movement disorders like TD via telehealth. While telehealth has many benefits in other areas, most clinicians replying on this topic felt that it actually increased the risk of a missed or incorrect diagnosis – undermining health outcomes or even harming patients.

With in-person visits, providers aren’t limited by what they can see on a screen. And patients cannot conceal physical symptoms out of embarrassment or anxiety. Clinicians catch involuntary or repetitive movements or physical tension throughout a patient’s body, which helps them diagnose the condition and work toward a personalized treatment plan.

There are times when telehealth fits well in a patient and provider’s schedule and treatment plan, or even necessary. But in some cases, such as movement conditions, meeting in person is the best way for providers and patients to develop a treatment path that delivers the best outcomes for them both.

Rimal Bera, M.D., is a clinical professor of psychiatry at the University of California, Irvine and serves as the Chairman of the Alliance for Patient Access Mental Health Working Group.


The Capital City Emergency “Level II” Trauma & Wellness Center will house a “state of the art” Outreach Community Resource Center, that will provide case management, mental health community advocacy, and oversight from the M.I. Mother’s Keeper mental health advocates. 
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