A pilot program in rural telepsychiatry for deaf and hard of hearing populations

Abstract

BackgroundAccess to mental health care in deaf communities is limited by cultural considerations, availability of translators, and technological considerations. Telepsychiatry can mitigate the deaf community’s lack of access to care by allowing for deaf individuals in remote communities access to care with facilities that cater to their needs.MethodsCommunity Behavioral Health, Arundel Lodge, and Gallaudet University worked in conjunction to test three hypotheses:Telepsychiatry will be as effective as traditional face-to-face psychotherapy with deaf adults who have chronic mental illness.Patients living in remote locations will report an improvement in accessibility to mental health services.Patients who receive telepsychiatry will report a comparable level of satisfaction of services to those receiving traditional services.The patient sample consisted of 24 participants, 13 women, 11 men. Telepsychiatry sessions were scheduled based on each patient’s individual treatment plan against a control group who saw their providers face to face.ResultsThe telepsychiatry and in-person groups were slightly different at baseline. Analysis of the data revealed no significant difference in coping abilities and psychiatric symptoms between those receiving face-to-face psychotherapy and those receiving telepsychiatry.InterpretationThe quality and outcome of care was equal to in-person for the telepsychiatry in deaf patients. Since telepsychiatry does not compromise the quality of care, it is a good means of reaching out to members of the deaf community that cannot readily access mental health resources that meet their needs.

Patients' and providers' experiences with video consultations used in the treatment of older patients with unipolar depression: A systematic review

“…Patients who completed the study are given in parentheses in Table 1. Seven studies were randomized controlled trials (RCTs) (Bishop, O'Reilly, Maddox, & Hutchinson, 2002;Egede et al, 2016;Fortney et al, 2007;Hilty, Marks, Wegelin, Callahan, & Nesbitt, 2007;Luxton et al, 2016;O'Reilly et al, 2007), six simple survey instruments (Crowe, Jani, Jani, Jani, & Jani, 2016;De Las Cuevas, Artiles, De La Fuente, & Serrano, 2003;Kobak, Williams, Jeglic, Salvucci, & Sharp,…”

“…First of all, a broad age range and different diagnoses in some studies make it difficult to identify the experiences related to depression in older people, and a confounding effect cannot be ruled out because of the mixed groups. According to the CASP criteria, the validity of study findings can be limited due to low sample sizes (Arnaert et al, 2007;Bishop et al, 2002;Crowe et al, 2016;De Las Cuevas et al, 2003;Frank et al, 2017;Greenwood et al, 2004;Jang et al, 2014;Kobak et al, 2008;Menon et al, 2001;P. Shore et al, 2014;Tang et al, 2001;Yeung et al, 2009), lack of power calculation in RCT studies (Bishop et al, 2002;Egede et al, 2016;Fortney et al, 2007;Luxton et al, 2016), and lack of explanation for data saturation in qualitative studies, as well as low response rates (Conn et al, 2013;Fortney et al, 2007;J.…”

What works for whom with telemental health? A rapid realist review

“…1) Working with service users to identify any family and friends whose attendance at care planning and other clinical meetings (including on inpatient wards) would be helpful, including those for whom telemental health would facilitate access, such as people in distant locations or whose commitments would make it difficult to attend face-to-face meetings; 2) using strategies as for service users to provide guidance on using telemental health to family and friends and to prepare them for appointments; 3) offering children and their families the opportunity to have telemental health appointments (or, if feasible, home visits) if they find it easier to participate as a family without having to travel to an appointment and to be seen in a clinical setting; 4) on inpatient wards, providing charged iPads, short cables or charging lockers to allow service users to charge their own devices so that they can use technology to connect with family or other supporters. CMO 2.4: Widening the range of available mental health services and treatments [59,[135][136][137] For service users who may benefit from services that they cannot readily access locally and that provide specialised forms of treatment and support regionally or nationally (C), telemental health can People to whom this is relevant may include: 1) people who have complex clinical needs or rarer conditions such that they would potentially benefit from assessment, treatment and support from specialist services provided at regional and 1) Development (including of funding arrangements) and dissemination of information about specialist services accessible via telemental health; 2) access for service users, their family and friends and clinicians to information and signposting regarding via telemental health widen the range of specialist assessment, treatment and support available (M), which potentially leads to improved access to services tailored to individual needs and culturally appropriate or specialist services (O1), and to improved satisfaction and treatment outcomes (O2), although an impoverished range of local face-to-face provision may be a risk if referral to distant specialist care via telemental health becomes routine (O3). national rather than local levels; 2) people who may be able to access distant therapists who speak their own language or interpreters of rare languages not available locally; 3) people who would benefit from support from voluntary organisations that meet specific needs not catered for locally (for example, that support particular cultural groups, LGBTQ+ groups, or people with sensory impairments); 4) people who would benefit from a wider choice of therapies and support (including peer support) than is available locally.…”

What is the efficacy and effectiveness of telemedicine intervention for Deaf signing populations in comparison to face-to-face interventions? A Systematic Review

“…In the study by Crowe et al (2016), it was not clear how participants were allocated to the face-to-face group or telepsychiatry group. It appears that the study groups were not similar at the start of the study as at the baseline, only mental health outcomes were compared.…”