Telepsychiatry – Making a Difference

The hurricane ravaged state of Texas may need more of this as it recovers from the monstrous Hurricane Ike. I certainly would need some calming if I have been anywhere close!

Mental health help for patients is just video screen away

Physicians turn to technology for virtual home visits

By BILL MURPHY Copyright 2008 Houston Chronicle

Sept. 10, 2008, 12:11AM

Fred Ramirez, a psychiatric nurse, watches a patient as she relates that her medicine hasn't been completely effective.

He notes the tremors in her hand, studies her face and, in the end, agrees with her.

All this happens with patient and counselor separated by 400 miles — Ramirez in his office at JSA Health in Houston and the patient at a clinic in the West Texas town of Big Spring.

Welcome to the burgeoning field of telepsychiatry, where couches in psychiatrists' offices have given way to video screens.

With a shortage of mental health workers in Texas and nationwide, patients needing treatment are relying on counselors hundreds, if not thousands, of miles away.

Children in El Paso, ranchers in West Texas and thousands of state prison inmates are among the patients availing themselves of telepsychiatric services.

"Telepsychiatry will rapidly become the fastest-expanding segment within psychiatry as a whole," said Avrim Fishkind, president and chief medical officer of JSA Health, which specializes in emergency telepsychiatric evaluations for emergency rooms, rural mental health centers, schools and jails. "Psychiatrists cannot possibly cover the 4,700 medical emergency rooms, inpatient units and intensive care units in the United States. In one day, I saw patients in four different Texas clinics that would have required me to drive over 600 miles in my car in a single day."

Fast-growing sector

Telepsychiatry is among the two fastest-growing sectors of telemedicine, said Jon Linkous, chief executive of the American Telemedicine Association. (The other is the monitoring of chronically ill patients through video conferencing.)

Telemedicine's growth, he said, can be seen in the number of videoconferencing hubs set up mostly by hospitals. There are 200 hubs, where doctors and specialists treat patients, at 3,000 clinic, schools and prisons nationwide.

The growth of telepsychiatry in Texas, in part, is related to the shortage of mental health workers — 184 of Texas' 254 counties have an inadequate number of counselors, according to the Texas Department of State Health Services.

Much more here

http://www.chron.com/disp/story.mpl/headline/metro/5992958.html

A side-box to the article discusses the key benefits

VIRTUAL AID

Supporters of telepsychiatry tick off a host of benefits:

• No driving: Psychiatrists can see many more patients via video teleconference than by driving to remote clinics or prisons.

• Fast: Patients in underserved and remote areas who might go untreated can receive counseling and often much more quickly than by visiting a clinic.

• Low costs: It's cost-effective. Transportation costs for patients and psychiatrists can be greatly reduced, and psychiatrists don't bill state prisons, say, for travel time.

While a little worried that a key use identified in the article was to provide psychiatric services to prisoners it seems effective use of the technology is being made and this is only to be encouraged in a State which admits to a shortage of mental health professionals – just as at least some States much closer to home do!

Well worth a read.

David.