Telepsychiarty: The Solution to Mental Healthcare Shortages?

Telepsychiatry is steadily growing into a robust industry. Telepsychiatry refers to a specific component of telemedicine which deals with the assessment and delivery of mental health care through telecommunications services, usually video conferencing. Insurance companies and medical providers are increasingly covering and providing psychiatry services for patients through telemedicine. Given the prevalence of Americans currently dealing with mental illness, this is a welcome development. The National Survey on Drug Use and Health reported that in 2014 18.1% of all US adults aged 18 or older had any mental illness (AMI) defined as:

·         A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders);

·         Diagnosable currently or within the past year; and,

·         Of sufficient duration to meet diagnostic criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Treating individuals with mental illnesses requires an enormous amount of medical resources and a dedicated number of mental health professionals. Unfortunately, in the U.S., according to the Department of Health and Human Services, there are over 4,000 mental health shortage areas. Essentially, in these regions the ratio of psychiatrist to patient exceeds 1:30,000. “Applying this formula, it would take approximately 2,800 additional psychiatrists to eliminate the current mental health HPSA designations.” Unless we see a dramatic increase of 2,800 psychiatrists tomorrow, most medical facilities and practices are unequipped to deal with the shortage of mental health care professionals. This is where telepsychiatry is beginning to play a crucial role in expanding access to care and relieving pressure on overburdened systems.

Those seeking care for mental health illnesses might be better positioned to receive care virtually, and emergency rooms can now offer virtual psychiatry sessions reducing the burden on ER staff. The growing telepsychiatry industry means broader access across the U.S., especially for U.S. veterans. Of the 1.7 million veterans who served in Iraq and Afghanistan, 300,000 (20 percent) suffer from post-traumatic stress disorder or major depression (RAND Center for Military Health Policy Research, Invisible Wounds of War, 2008). Most Veterans will not seek treatment from VA system psychiatrists or health professionals. MyOnCallDoc President and CEO, Craig Zurman, created the international telemedicine services solution provider MyOnCallDoc to help address this very need. While working with the U.S. Department of Veterans Affairs, the need for a comprehensive, affordable, and quality telepsychiatry program was overwhelmingly apparent. Now, MyOnCallDoc features a robust network of providers able to offer psychiatry services at affordable rates, bringing the care people need directly to their homes. 

While telepsychiatry is a rapidly expanding industry,  there are still challenges and barriers to its implementation. Most insurance companies do not have regulations in place to allow for telepsychiatry reimbursement. The number of insurance companies or employer provided health programs that offer coverage for these services is expanding, but not quickly enough. Other times, psychiatrists may only consult with patients located in the state in which the psychiatrist is licensed due to very specific licensing requirements. Training can also be an issue, simply because a psychiatrist has access to the technology does not mean they have been adequately trained to handle virtual sessions. Fortunately, the American Telemedicine Association has put together guidelines for video-based mental health services. The guidelines are comprehensive and address technical, clinical, and administrative processes. 

As long as psychiatrists remain open to offering psychiatry sessions via telecommunications, patients are amenable to participating in virtual sessions, and patient outcomes continue improving, telepsychiatry stands to help provide broader access to mental health services for at-risk and vulnerable populations and reduce health care costs in the long run.

For more information, please contact MyOnCallDoc to speak with one of our psychiatrists today.

MyOnCallDoc GenderCare: Transforming Healthcare for Transgender and LGBT Communities

Recognizing the resounding barriers to health care for the LGBT community, MyOnCallDoc and The World Professional Association for Transgender Health (WPATH) are partnering together to establish a pilot program that will allow doctors and psychiatrists who have received specific training to address the needs of transgender individuals through telemedicine. When MyOnCallDoc began investigating the current health care environment for transgender individuals and those in the LGBT community, WPATH was the only organization actively training health care professionals in the intricacies of treating transgender patients. Through this partnership, MyOnCallDoc will be introducing an entirely new focus program called GenderCare. The MyOnCallDoc GenderCare pilot program will allow doctors from WPATH’s trained community to offer 24/7 telemedicine and telepsychiarty care to the LGBT and transgender communities. The mission of the program is to expand access to quality, affordable care for LGBT patients through telemedicine services. WPATH is also working with insurance companies to increase the number of services that are covered for a transgender patient.

MyOnCallDoc was founded on principals of inclusion and providing broader access to high-quality, affordable health care services for ALL individuals. These are the principles that continue to guide our development of new projects and programs. Most recently, we have been researching barriers to access for those within the transgender and LGBT communities. Unfortunately, the realities surrounding discriminatory practices in health care and with insurance companies for LGBT individuals can be disheartening. As transgender individuals attempt to address their mental and physical needs, they are often denied care and access to medical health professionals – even for episodic conditions. Most individuals have stated they have refrained from seeking care because of perceived discrimination or denial of care. The National Transgender Discrimination Society reported that, “health outcomes for all categories of respondents show the appalling effects of social and economic marginalization, including much higher rates of HIV infection, smoking, drug and alcohol use and suicide attempts than the general population.” It was also reported that transgender people experience over 4 times the national rate of HIV infection.

While the realities can be sobering, it is incredibly important to celebrate the small steps in legislation and standards that have been enacted recently that prohibit LGBT, gender non-conforming and DSD individuals from being denied health care services and coverage. The Affordable Care Act which “prohibits sex discrimination in hospitals and other health programs or facilities receiving federal financial assistance as well as bias based on race, national origin, age, and disability,” is a first rate example. While this covers all health programs and facilities that receive federal funding assistance, there are plenty of individuals seeking care within the LGBT community that don’t have access to any of these programs. Additionally, there are many organizations and companies working to transform the status quo and expand health care access. WPATH is committed to transgender health and formulating strategies and care that address the full spectrum of needs for those with gender identity disorders. Their vision is to, “bring together diverse professionals dedicated to developing best practices and supportive policies worldwide that promote health, research, education, respect, dignity, and equality for transgender, transsexual, and gender-variant people in all cultural settings.” WPATH has already trained over 1300 medical health providers and continues to offer a Transgender Health Certification Course. Through WPATH’s commitment to elevating transgender health care, thousands of individuals now have access to medical resources, scientific research studies, organizations, a community of like-minded individuals, and trained professional health care providers. If you have questions about Gender Care or wish to be connected to a provider, don’t hesitate to call MyOnCallDoc at 855-362-3278 or visit our website.

Organizations providing further information:

• National Center for Transgender Equality – “The National Center for Transgender Equality is the nation’s leading social justice advocacy organization winning life-saving change for transgender people.” http://www.transequality.org/know-your-rights/healthcare
• Lambda Legal – “Founded in 1973, Lambda Legal is the oldest and largest national legal organization whose mission is to achieve full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people and those with HIV through impact litigation, education and public policy work.” http://www.lambdalegal.org/issues/health-care-fairness