Tuesday, May 31, 2016

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.


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