March 16, 2016

Despite Hurdles, Telepsychiatry Use Rising

I admit that the terms used to help people with mental health are somewhat confusing and I don't know why the authors have to muddy the information and try to confuse people, especially those looking for services being offered in underserved areas of the United States.

The first term is telemental health and it is described as a rapidly growing field. It is used in a range of settings for patients with a variety of disorders. The second term is telepsychiatry. Then they use my favorite term, telemedicine and the last term is telehealth.

According to a 2014 report by the U.S.Department of Health and Human Services there is a major shortage of psychiatrists. The report states that there are 4,000 shortage areas in which there the psychiatrist-to-resident ratio is equal to or greater than 1:30,000.

Researchers continue to find support for its use in evaluating or treating an ever-expanding list of psychiatric disorders, including some of the latest studies involving attention-deficit/hyperactivity disorder, schizophrenia, post-traumatic stress disorder, and autism. Many of these studies investigated the efficacy of treatment delivered via video as compared to in person and have found that services delivered by video are at least as effective as in-person visits.

Most people have a high-speed connection even in rural areas although some of the 4,000 shortage areas do not have this. As potential applications of telemental health have expanded, many aspects of delivering care via video have eased considerably over years. The sound quality has improved while the occurrence of glitches like freezing has decreased.

However, some of the barriers that have hampered its use remain unchanged or are changing very slowly. Though some insurance companies now cover telehealth services, many do not. Clinicians should check with any insurance companies they work with to inquire about reimbursement for telehealth services.

In 2009, the American Telemedicine Association published Practice Guidelines for Video-Conferencing-Based Telemental Health that highlights necessary clinical and technological competencies, and the American Psychological Association released guidelines in 2013.

“The practice of telepsychology involves consideration of legal requirements, ethical standards, telecommunication technologies, intra- and interagency policies, and other external constraints, as well as the demands of the particular professional context,” the authors wrote.

Therapists providing services via telehealth should receive ongoing training, and they should check with the licensing laws and policies of the insurance companies with whom they are contracted to stay up to date on inevitable changes to come.

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