Overcoming Barriers to Larger-Scale Adoption of Telepsychiatry

Abstract

Despite the staggering physical, economic, and societal costs of mental health conditions in the United States, there continues to be a significant gap in mental health service, as access lags behind the demand for them. The uneven distribution of mental health service providers contributes to this gap, making it necessary to incorporate novel approaches to the delivery of mental health services. Telepsychiatry has proven to be one of the more innovative approaches for improving access to mental health services. This article focuses on six challenges that have historically impeded larger-scale adoption of telepsychiatry: limited training, limitations of existing research, security and technology issues, clinical practice challenges, licensure, and reimbursement restrictions. The article discusses recent developments, ongoing advances, and future directions to overcoming these barriers. [ Psychiatr Ann . 2019;49(2):82–88.]

Telemental Health in the Context of a Pandemic: the COVID-19 Experience

“…Among its many proven advantages, its most pertinent utility to the current situation is to expand access to care for hard-to-reach and underserved populations with restricted mobility due to mental, medical, or geographical challenges. Telemental Health reduces or eliminates the need for travel for both patients and clinicians and delivers remote services costeffectively while maintaining the quality of care [13]. As a result, in times of public health crises and national and international emergencies, the value of Telemental Health cannot be overstated.…”

“…Lobbying for policy reforms by professional societies, such as the American Telemedicine Association and American Psychiatric Association, is needed to achieve this goal, particularly that the Act was passed in 2008 [18], and the landscape of Telemental Health has rapidly evolved since. & Given that state licensure has been a documented barrier to the expansion of Telemental Health [13], it is crucial to temporarily suspend restrictions on licensure requirements to practice Telemental Health across state lines, to regions of the country that are most impacted by the pandemic [19]. In the long term, it is important to expand processes that facilitate interstate licensure for better preparedness for future crises.…”

Planning and Implementing Telepsychiatry in a Community Mental Health Setting: A Case Study Report

“…In fact, according to recent data, a staggering 4347% increase in telehealth videoconference use was noted as a response to the limitations imposed by the COVID-19 (Gelburd 2020 ). Despite that, significant challenges associated with its implementation continue to be reported (Hossam Mahmoud et al 2019 ), and more reports are needed to document the planning and implementation experiences of successful telepsychiatry programs, in order to examine associated processes and factors and to facilitate adoption.…”

“…In addition, videoconferencing aligned with the Center’s strategy for improving overall efficiency and quality in healthcare services through expanding the use of healthcare technologies, including electronic health record (EHR) and e-prescribing. This was reinforced by the extensive literature documenting the acceptability and effectiveness of telepsychiatry as a method of mental healthcare delivery, with outcomes similar to in-person care (Chan et al 2015 ; Hossam Mahmoud and Vogt 2019 ; Hossam Mahmoud et al 2019 ; Salmoiraghi and Hussain, 2015 ). Telepsychiatry had become more feasible due to improved connectivity, availability, and affordability of technology, both hardware and software (Ray Dorsey and Topol 2016 ; Spivak et al 2019 ).…”

“…The Center sought the help of Regroup Telehealth, which provides integrated telemental health services that would ensure collaboration among different healthcare providers while minimizing disruptions to the center’s new workflow. This was driven by the evidence in the literature and recommendations supporting telemental health integration (ATA 2013 ; Fortney et al 2015 ; Mahmoud et al 2020a ; Hossam Mahmoud et al 2019 ).…”