What is Telepsychiatry?
Telemedicine is the application of medical practice through the use of the Internet and telephones. When we use this process to provide specialized medical care for brain disorders, it’s called Telepsychiatry. This guide will help you understand what telepsychiatry is, how it works, its benefits, and how you can pay for it.
Telepsychiatry is the specialized extension of telemedicine that focuses on providing psychiatric medical services to those in need through an electronic medium, usually via the Internet or via telephone. Telepsychiatry is often described as the “delivery of medical care and exchange of health care information.”
Telepsychiatry includes all the services provided through a psychical psychiatric establishment like:
- Diagnosing the mental disorder
- Developing a treatment plan
- Providing emotional support and advice
- Work with the patient to manage the illness
Telepsychiatry is one of the most common forms of telemedicine because of the nature of psychiatry. Since most of the evidence required to make a correct diagnosis can be gathered audio-visually and there is little need for physical tests, psychiatry is very well suited for telemedicine. Moreover, you only require minimal equipment to make telepsychiatry a viable alternative to hospitals and clinics.
Due to the technological advancements in video conferencing abilities and the increasingly hectic schedules for most people, telemedicine has become much more popular. But it’s not new. Telepsychiatry was first practiced in the 1950s and 1960s by the Nebraska Psychiatric Institute. The institute used “closed circuit television for medical education purposes, followed by group psychotherapy, consultation, assessment, collaboration, and teaching.
US-based telepsychiatry was growing at a rapid pace with the number of consultants increasing from 948 in 1994 to more than 8640 in 1998. With the arrival of the Internet and more affordable equipment, telepsychiatry is becoming even more popular.
How does Telepsychiatry Work?
At the very least, patients require a mechanism that can “store and forward” information between the patient and the therapist for telepsychiatry to work. This can be an email or video messages where both the therapist and patient can participate in the session at their own convenience, at different times.
The more common form telepsychiatry uses real-time mechanisms like video conferencing or telephones – all you need are good audiovisual peripherals and a good Internet/telephone connection. The session generally starts with a phone call where the physician gets the health history of the patient including any past mental disorders. Physicians can then help diagnose a mental disorder or emotional problems, monitor and manage the illness, provide medical information, discuss treatment options, and start treatment. Telepsychiatrists can also refer the patient to other health professionals if needed.
Why Telepsychiatry is Getting Popular?
There are some clear benefits to opting for telemedicine over traditional health care. These benefits are even more pronounced for telepsychiatry. Benefits such as:
1. Access
This is the primary reason telepsychiatry exists – so that everyone can access quality medical care, irrespective of their location. Telepsychiatry overcome the barriers that come with accessing a hospital or clinic such as transportation, transportation costs, time limitations, and lack of medical establishments in less developed areas.
In 1989, the Georgia State-wide Telemedicine Programme (GSTP) began and “during the first year, 180 clinical consultations were conducted and high levels of satisfaction were expressed by both patients and clinicians.” More recently, research was conducted in the rural Northwestern United States to understand the effects of telepsychiatry in rural areas. The study found that telepsychiatry increased access to psychiatric help and that telepsychiatry is a viable means of treatment. Telepsychiatry is especially beneficial to college students who might not be able to access quality psychiatric help from within their college campus.
Telepsychiatry is also very useful n countries like the USA and Canada where 25 percent of the population lives in rural areas. For example, when a comprehensive telepsychiatry programme began in Georgia in 1994, there were no psychiatrists in all of Georgia’s 159 counties (there still aren’t many). Telepsychiatry can be a lifesaver, overcoming problems of distance, traffic, terrain, and climate.
2. Costs
There is limited data about telemedicine from an economical perspective but one thing is clear: telepsychiatry is more affordable than conventional treatment. The cost savings depend on factors such as frequency of sessions, distance to the clinic/hospital, rural or urban settings, etc.
Multiple studies have confirmed the cost-effectiveness of telepsychiatry. For instance, in many rural areas, utilizing telepsychiatry can lead to cost reductions anywhere from 40 percent to 70 percent. In another case, patients found savings of “around $30,000, for 278 telepsychiatry visits to nursing home residents”.
3. Overcoming Stigma
Only recently people have started to open up about mental health and realized the reality of brain disorders and how they can wreak havoc on people’s lives. However, there’s still much progress to be made in this department. There are still communities around the world that discard the concept of psychiatry. Furthermore, pop culture has painted individuals with brain disorders as violent, dangerous people, or somehow weaker than others.
Certain demographics, such as men, are at an even greater risk of endangering their emotional and mental health because of the false perception that men should not be emotionally distressed, and fail to reach out for help. However, not getting professional help can negatively affect a person’s life and those around him.
Telepsychiatry can help people overcome stigma by allowing individuals to get the help they need at their own pace, in their own safe space where they cannot be judged by others.
It may seem harder to open up to someone on a screen rather than talking face to face, the American Psychiatric Association says that people are actually more comfortable during the telepsychiatric session.
“Some people may be more relaxed and willing to open up from the comfort of their home or a convenient local facility. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life.”
4. Easier Follow-Up
One of the biggest issues with any form of medical treatment is the follow-up. Majority of the time the patient receives an initial round of treatment and as soon as they feel better, they stop their treatment. They might stop the treatment because they do not want to visit the hospital or clinic again or because it’s too much of a hassle or because they cannot make time for it.
Telepsychiatry can help tackle this issue by reducing the need to make trips to the physician’s office and bringing medical help directly to where the patient is. This will also help avoid delays in treatment or appointments as the patient won’t need to take a lot of time out of their daily schedule.
Quality and Effectiveness of Telepsychiatry
It has been a long-held belief that telepsychiatry cannot provide the same level of quality as the traditional type of medical care. Many believe that in order to receive correct and complete treatment, the patient needs to be in the room as the physician so that he can perform a physical examination. However, these doubts have been disproven by multiple studies.
Due to the advancements in audiovisual technology and a vast amount of information that psychiatrists have, it’s much easier now to make a correct diagnosis than it was ever before. For instance, in one study that examined the “percentage of times when a physician has given the correct diagnosis” found that “83 percent of patients who were diagnosed per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) through the use of telepsychiatry was correctly diagnosed.”
The American Psychiatric Association also approves of telepsychiatry as an effective means of receiving proper medical care. The APA says
“Telemedicine in psychiatry, using video conferencing, is a validated and effective practice of medicine that increases access to care. The American Psychiatric Association supports the use of telemedicine as a legitimate component of a mental health delivery system to the extent that its use is for the benefit of the patient, protects patient autonomy, confidentiality, and privacy; and when used consistent with APA policies on medical ethics and applicable governing law.”
Paying for Telepsychiatry
Like traditional face-to-face psychiatric sessions, the most common method of payment for telepsychiatry is private pay or out-of-pocket pay. However, according to the American Telemedicine Association, thirty-four states and the District of Columbia legislated that private insurance must cover telemedicine like they cover face-to-face health care services.
Telemedicine (and telepsychiatry) is also covered under Medicare to some extent. The American Telemedicine Association says.
“Medicare covers physician services using video conferencing and remote patient monitoring. The ~14 million beneficiaries in Medicare Advantage (managed care) plans have complete flexibility in using telehealth, as long as their provider offers the service.”
Medicaid also covers telepsychiatric care if the patient is in a rural community.