Three things go wrong on video appointments, and they go wrong in the same order every time. The microphone is muted. The browser has not been given permission to use the camera. The connection wobbles at the worst possible moment. All three are fixable in under a minute if you know what you are looking at, and all three are much easier to sort out the day before than at two minutes past your appointment time.
This guide is deliberately platform-neutral. Clinics use different video systems and yours will send you joining instructions; what follows applies whichever one you are handed.
What you actually need
Less than people expect.
A device with a camera and microphone. A smartphone from the last several years, a tablet, or a laptop with a built-in webcam. A desktop computer needs a webcam plugged in. That is the whole hardware list.
A connection that holds up. Home broadband over Wi-Fi is usually fine. Mobile data works well on a decent 4G or 5G signal. What causes trouble is a weak Wi-Fi signal at the far end of the house, a connection shared with someone streaming or gaming, and public Wi-Fi in cafés and hotels, which is often both slow and not private.
Headphones or earbuds. The single biggest improvement for the least effort. They stop the psychiatrist’s voice being audible in the room, they cut echo, and their microphones handle quiet speech well. Wired ones cannot run out of charge.
A quiet room with a door. Sound matters more than scenery. A soft room — curtains, carpet, a bed — sounds better than a kitchen with hard surfaces. There is more on the privacy side of this in the guide on keeping your video consultation private.
Light on your face. Sit facing a window or a lamp. A window behind you turns you into a silhouette, which makes it harder for a clinician to see your expression, and expression is part of what they are assessing.
Test it the day before
Not five minutes before. Testing early leaves room to fix something.
- Open your joining link on the device you plan to use. Many systems open a pre-call check or a waiting area where you can see yourself and watch a microphone level move as you speak. If yours does, you are done.
- If there is no test page, open the device’s own camera app, record ten seconds of yourself talking, and play it back. Camera and microphone both work if you can see and hear yourself.
- Check your headphones are the chosen output. Plug them in or pair them before you join, not after. Switching audio devices mid-call is where sound tends to vanish.
- Run the link on the actual device, not a different one. Permissions are set per device and per browser.
- Note the fallback. Find the phone number for the clinic and save it in your contacts. This is the step people skip and then regret.
If you have never used video calls much, a five-minute practice call with a friend is worth more than any checklist.
Camera and microphone permissions
Most difficulties that look like broken hardware are permissions.
When a website first wants your camera, the browser asks. Say yes, and it works. Say no — or tap the wrong thing while distracted — and the browser remembers the no, silently, for next time. You then see a black square and assume the camera is faulty.
The fix is always in the same place: the small icon at the left of the address bar, usually a padlock or a slider. Tap or click it and you will see camera and microphone listed, with whatever answer was given last time. Change it to allow and reload the page.
On phones and tablets there is a second layer. The browser or app itself needs camera and microphone permission from the operating system, in the device settings under privacy or under the app’s own entry. If the browser has no permission, no website inside it can have any either.
Two more things worth knowing. Only one app can hold the camera at a time, so close any other video app that may still be running in the background. And work laptops sometimes have camera or microphone access blocked by an IT policy, which you cannot override yourself — a reason to use your own device where you can.
Phone or laptop
Both work. They fail differently.
| Phone | Laptop | |
|---|---|---|
| Setup | Fewer settings to get wrong | More control, more to configure |
| Camera position | Needs propping up; handheld is tiring and shaky | Stable, but often angled up at the ceiling |
| Sound | Good with earbuds | Good with headphones; built-in speakers cause echo |
| Interruptions | Calls and messages arrive mid-consultation | Fewer interruptions |
| Connection | Mobile data as well as Wi-Fi | Usually Wi-Fi only, but can be wired |
| Notes and documents | Awkward to read from | Easy to have a list on screen |
| Battery | Drains fast on video | Longer, but plug in anyway |
A reasonable compromise for a long first assessment: laptop plugged in, propped at eye level on a couple of books, wired headphones, phone on silent beside you as the backup. For a 20-minute follow-up, a propped-up phone on earbuds is perfectly adequate.
Battery, notifications and interruptions
Plug in. An initial assessment usually runs around an hour, and video is the most power-hungry thing most devices do. Low-power mode can also throttle performance, which degrades the call.
Silence notifications properly. Do not disturb or focus mode on the device, and on a laptop close messaging apps rather than minimising them. Two reasons: a banner sliding across your screen is distracting, and if you ever share your screen, it is also a privacy problem.
Prop the device up. Holding a phone for an hour produces an aching arm and a moving picture. Anything that props it at eye level will do.
Tell the household. A note on the door beats an interruption. If you cannot guarantee privacy at home, a parked car — parked, not moving — is a common and surprisingly good option.
When the call drops or the sound fails
Work through this in order. Most problems fall at the first step.
- Check mute first. Both the platform’s own mute button and any physical mute switch on your headset. If the psychiatrist can see you but not hear you, this is almost always it.
- Silence, one-way. Check the output device is what you think it is. Unpair and re-pair Bluetooth headphones, or plug in wired ones.
- Frozen or stuttering picture. Turn your own camera off for a minute. Audio needs far less bandwidth than video, and a conversation with no picture is much better than no conversation.
- Everything grinding. Close other tabs and apps, and ask anyone at home to pause a stream or download.
- Weak Wi-Fi. Move nearer the router, or switch the device to mobile data.
- Dropped call. Rejoin using the same link. Links are usually reusable for the duration of the appointment.
- Still nothing after a couple of attempts. Phone the clinic rather than continuing to retry.
Mobile data is the backup that rescues most calls. If your home connection is unreliable, decide in advance that you will switch rather than spending ten minutes of your appointment hoping the Wi-Fi recovers.
What a clinician does if the connection fails mid-assessment
This happens, and clinics plan for it. You are not going to lose the appointment because of a router.
Most clinicians will confirm a phone number at the start of a first appointment for exactly this reason. If video fails and cannot be restored, the usual sequence is: wait a minute for you to rejoin, then telephone you. An assessment can often be completed over the phone, though a clinician may decide that some parts need video and arrange to finish then — particularly for a first assessment, where seeing you matters.
If a substantial part of the appointment was lost, ask what the position is on time and fees; Happy Clinic’s terms and current prices are on its fees page. What a clinician will not do is rush a diagnosis to fit a broken call. If the information is not there, the honest answer is a second appointment.
For the shape of the appointment itself, see how it works and the guide on preparing for your first video appointment. If you are still weighing up whether remote care suits you, is telepsychiatry right for me has a checklist — an unreliable connection or nowhere private to talk is a genuine reason to think again.
A video appointment is not a crisis service. If a life is at risk, call 999 or go to A&E. For urgent mental health help call NHS 111 and, in England, choose the mental health option. Samaritans are on 116 123, free, 24 hours a day.
This article is general information, not personal medical advice. If you are worried about your mental health, speak to a doctor. In a crisis call 999 or NHS 111.
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