From a population health perspective, the mental health care system in the USA faces two fundamental challenges: (1) a lack of capacity and (2) an inequitable geographic distribution of services. Telepsychiatry can help address the equity problem, and if applied thoughtfully, can also help address the capacity problem. In this paper we describe how telepsychiatry can be used to address the capacity and equity challenges related to the delivery of mental health services in rural areas. Five models of telepsychiatry are described, including (1) the traditional telepsychiatry referral model, (2) The telepsychiatry collaborative care model, (3) the telepsychiatry behavioural health consultant model, (4) the telepsychiatry consultation-liaison model, and (5) the telepsychiatry curbside consultation model. The strong empirical evidence for the telepsychiatry collaborative care model is presented along with two case studies of telepsychiatry consultation in the context of the telepsychiatry collaborative care model. By placing telepsychiatrists and tele-therapists in consultation roles, telepsychiatry collaborative care has the potential to leverage scarce specialist mental health resources to reach more patients, thereby allowing these providers to have a greater population level impact compared to traditional referral models of care. Comparative effectiveness trials are needed to identify which models of telepsychiatry are the most appropriate for patients with complex psychiatric disorders.
Quality improvement processes resulted in the implementation and evaluation of 5 detection and treatment processes. Though varying by site, screening improved detection and a substantial number of patients received consultations and medication adjustments; however, symptom improvement was modest. (PsycINFO Database Record
Petrochemical operators view the distributed control system process through operating graphics that are displayed on four or more cathode ray tube displays that are monitored 24/7. The graphics vary in both design and content, however there has not been extensive research done on the ability of vector arrows to display this trend information. The purpose of this study was to understand the current trend representation methods and to develop efficient trend representation displays. Results indicate that providing vector arrows for trend representation can be effective in getting the attention of the user and can help in reducing change blindness. Results also indicate that between 10 and 20 degrees of change a participant notices change and that any rate of change increase beyond that does not improve their recognition, illustrating the importance of capturing the rate of change within this range in representing trend data. We were able to demonstrate that use of vector arrows for at-a-glance initial trend analysis was easy to use and effective in petrochemical industry systems.
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