Videoconferencing – Changing the Face of Mental Healthcareby Jennifer Gibson, PharmD | May 29, 2013
It is not noteworthy (or particularly blog-worthy) news that mental health care is not up to par, especially in the United States. What is noteworthy is the up-and-coming technology that might change mental healthcare provision for the better.
Inadequate resources and limited access prevent people most in need of mental health care from getting any care at all. Most psychiatric services are concentrated in urban areas, leaving rural populations on the wasteland side of the great healthcare divide.
But, there is good news, thanks to rapidly improving communication and information technologies. Telepsychiatry, sometimes referred to as e-mental health, provides psychiatric treatment, diagnosis, and medication management, via live interactive videoconferencing. With this technology, patients who once had no access to medical specialists can receive appropriate, timely, and individualized mental healthcare from the comfort of their own home, or at least within their own community.
Telemedicine was pioneered by medical visionaries in the 1960s. The early technology consisted of two-way black and white televisions with poor audio and video quality. Despite its limitations and high costs at the time, telemedicine did improve access to quality healthcare across all disciplines for patients in remote areas. As technology and communication improved over the next several decades, so did the provision of telemedicine. Psychiatry emerged as a specialty that was particularly well-suited to long-distance patient-provider relationships. And, telepsychiatry offered never before seen opportunities for group therapy.
While patients living in rural or remote areas might feel few and far between, when these patients are assessed collectively, mental illness occurs in the same proportions as in urban populations. And, these patients, via communication technology, can meet and receive support from patients facing similar mental health issues.
In just the past few years, much attention has been paid to outcomes in telepsychiatry, and it is proving to be an acceptable alternative to face-to-face therapy. Telepsychiatry has been used for direct patient care, consultation, training, education, and research purposes.
It is not without its drawbacks, however, and even proponents of the practice cite administrative, clerical, and logistic difficulties. Critics of telepsychiatry believe that security concerns related to transmitting private health information must be addressed before telepsychiatry can become a comfortable everyday practice. Allocation of resources is another challenge facing this practice. Telepsychiatry does not necessarily use more resources, but it does redistribute them. With already limited resources in healthcare, reassigning personnel, equipment, and money to programs that are unproven and not commonly accepted is anathema.
Telepsychiatry shows great promise, but it will require changes in the attitudes and perspectives of healthcare providers and patients. New methods of healthcare delivery and collaboration are necessary for its acceptance, and telepsychiatry is outside the box of traditional medicine. Telepsychiatry can benefit patients by providing much needed care and support, especially in rural and remote areas, and it can benefit providers by offering collegial support, respite for over-worked psychiatrists, and reducing isolation for providers in small sub-specialties. The channels that people use to obtain and provide healthcare will be changing, and telepsychiatry may offer the adaptability and accessibility needed to change the way mental healthcare is viewed.
Chipps J, Brysiewicz P, & Mars M (2012). Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence. African journal of psychiatry, 15 (4), 235-43 PMID: 22829225
García-Lizana F, & Muñoz-Mayorga I (2010). What about telepsychiatry? A systematic review. Primary care companion to the Journal of clinical psychiatry, 12 (2) PMID: 20694116
Grady B (2012). Promises and limitations of telepsychiatry in rural adult mental health care. World psychiatry : official journal of the World Psychiatric Association (WPA), 11 (3), 199-201 PMID: 23024682
Malhotra S, Chakrabarti S, & Shah R (2013). Telepsychiatry: Promise, potential, and challenges. Indian journal of psychiatry, 55 (1), 3-11 PMID: 23441027
Shore JH (2013). Telepsychiatry: videoconferencing in the delivery of psychiatric care. The American journal of psychiatry, 170 (3), 256-62 PMID: 23450286
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