How Telemedicine is Helping Mental Health PatientsTelemedicine and its technological innovations may help to reach mental health patients who otherwise might go untreated or be underserved. A growing body of evidence indicates that telemedicine is uniquely suited to treat patients with mental health problems, particularly those who live in areas where psychiatric care is either limited or absent altogether.
In a recent article posted at USAToday.com, AP correspondent Jamie Stengle explains that psychiatrists are increasingly turning to telemedicine technologies to reach out to patients in need of their services but geographically distant from their offices.
PTSD Treatment via Telemedicine
Stengle recounted the case of 60-year-old Vietnam War veteran Anthony Presciano, who is suffering from post-traumatic syndrome disorder. Living in the small North Texas town of Argyle, Presciano told Stengle that he probably would not have received treatment for PTSD if he had had to make the 60-mile road trip to Dallas to see a psychiatrist.
Today, Presciano drives 15 miles or less from his hometown to a suburban clinic in nearby Denton where he can connect with his Dallas psychotherapist via a video hookup. Of his interaction with patients over video, Umar Latif, M.D., a psychiatrist at the Dallas VA Medical Center, said, “Once the telemedicine session starts, it’s no different than a face-to-face.” The Dallas center has had telemedicine-enabled psychiatric sessions for more than a year.
Increased Use across the US
Stengle reports that the use of telemedicine to provide mental health care is increasing at the state and local level around the country. In Pennsylvania, he reports, the Central Greene School District has been using telepsychiatry since the fall of 2014 to treat troubled students. Prior to the introduction of telemedicine-enabled psychiatric counseling, students in the rural district were forced to travel long distances to receive psychiatric care, according to School District Superintendent Jerome Bartley. “We have a great shortage of any kind of psychiatric outlets for students.”
In New Mexico, a number of primary care doctors have installed video hookups to facilitate consultations between drug treatment specialists and patients who are experiencing problems with substance abuse.Reaching Out to Rural Patients
In rural Georgia, Blue Cross, the state’s largest health insurer, is building a telemedicine network to connect rural health clinics and hospitals to teaching hospitals. Included in this new network are three psychiatric centers whose doctors can provide mental health care for patients in rural areas. Blue Cross spokeswoman Cindy Sanders told Stengle, “We saw the need when we surveyed rural sites. We asked, ‘What do you need, as far as specialists?’ Psychiatry was the number 1 need that we found.”
At the University of Texas Medical Branch in Galveston, telemedicine has been in use for a number of years. Its spokesman told Stengle that roughly one-third of their 60,000 annual appointments are for mental health care.
Telemental Services in SC
Further evidence of the impact that telemedicine can have on mental health treatment came recently from the Medical University of South Carolina where telemedicine is increasing referrals to specialists in psychiatric care. One enthusiastic supporter of MUSC’s Center for Telehealth and its Virtual Tele Consultation service is pediatrician James Simmons, M.D., who practices in Port Royal, roughly 75 highway miles from MUSC’s hub in Charleston.
Eager to utilize the services now available through telemedicine, Dr. Simmons says he uses his access to MUSC’s telemedicine network to refer his young patients to pediatric subspecialists, including dermatologists, nutritionists, and psychiatrists.
Dr. Simmons cites a recent case in which he was seeing a child struggling in school. Thinking the child could benefit from psychiatric intervention, he broached the subject with the child’s mother, who agreed to give it a try.
Video Consultation Set Up
Dr. Simmons arranged for a video consultation with M. Frampton Gwynette, M.D., a psychiatrist at MUSC in Charleston. Dr. Gwynette consulted first with the patient, who suffers from attention deficit disorder, and then confided his findings to Dr. Simmons. Among those findings was the startling revelation that the child was having suicidal thoughts. Working together, Drs. Gwynette and Simmons put together a treatment plan for the child, who is doing much better these days, according to his mother.
The benefits of psychiatric consultations via telemedicine were also made clear in a study of nearly 100,000 patients that compared outcomes both before and after enrollment in the telemental health services program of the U.S. Department of Veterans Affairs. Published in the April 2012 issue of “Psychiatric Services,” the study compared the number of inpatient psychiatric admissions and days of psychiatric hospitalization among 98,609 patients for the six months before and the six months after they enrolled in telemental services. The study was conducted over a four-year period from 2006 to 2010, and its findings were eye-opening.Hospitalizations Decline
Researchers found that psychiatric admissions for patients declined by an average of 24.2 percent in the six months after they began the telemedicine-enabled psychiatric consultations. On top of that, patients in the study group spent an average of 26.6 percent fewer days in the hospital after enrollment in the telemental services program. These results were observed in both male and female patients and in 83.3 percent of the age groups.
Authors of the VA mental health study were Linda Godleski, M.D., Adam Darkins, M.D., and John Peters. Dr. Godleski is affiliated with Yale University’s Department of psychiatry, as well as the VA’s National Telemental Health Center in West Haven, Connecticut. Dr. Darkins and Mr. Peters work with the VA’s Office of Telehealth Services in Washington, D.C.
Discussion of Study’s Findings
In their discussion of the study’s findings, its authors acknowledge that they “cannot rule out explanations for decreased hospitalization rates that are unrelated to the telemental health intervention.” However, they point that the overall population of VA mental health patients not only saw no similar decrease in hospitalizations but in fact experienced a small rise in the rate of inpatient care and little change in the number of days of hospitalization.
Elsewhere, Indiana is using telemedicine to increase the access of Medicaid patients to mental health care via telemedicine, according to a recent article posted at the website of the Association of Health Care Journalists. According to John Wernert, M.D., a psychiatrist who heads the state’s Medicaid operations, Indiana is utilizing telemedicine to provide psychiatric and other mental health services to patients, including those with relatively mild behavioral health problems.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.