Telepsychiatry is Rising in Popularity, Despite Hurdles

Telemedicine-based Psychotherapy Benefits Veterans With PTSD
Telemedicine-based Psychotherapy Benefits Veterans With PTSD
Telepsychiatry could help with the major shortage of psychiatrists in the US.

Telemental health is a rapidly growing field that is being used in a range of settings for patients with a wide variety of disorders. The surge in the use of this modality — also sometimes referred to as telepsychiatry, or more broadly, telemedicine or telehealth — is timely, given the major shortage of psychiatrists noted in 2014 by the U.S. Department of Health and Human Services.1

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. Meanwhile, “the fastest-growing sector of adoption for telehealth is the behavioral sciences,” Mary K. Alvord, PhD, a psychologist and practice director in Maryland and adjunct associate professor at George Washington University School of Medicine, told Psychiatry Advisor.

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,2,3 schizophrenia,4 post-traumatic stress disorder ,5,6 and autism.7 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. Numerous other studies show support for the use of telemental health in hospital emergency departments to help improve patient access and to aid onsite providers.8,9,10

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. The cost and quality of video technology have improved significantly while internet access, which was once a major concern for telemedicine proponents, “has expanded so beautifully that it has receded as a primary issue,” says Dr Alvord, who presents on the topic of telemental health at conferences and other events, and whose practice includes an interactive video component.

“Most people have a high-speed connection even in rural areas,” she added, noting that another change is that both patients and providers are becoming more comfortable with the concept, and “young people don’t even think anything about it.” 

However, some of the barriers that have hampered its use remain unchanged or are shifting 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.