Pediatric Telepsychiatry in Ontario: Caregiver and Service Provider Perspectives

Abstract

Families in rural areas face significant geographic and economic obstacles to obtaining pediatric mental health services. Telepsychiatry promises the possibility of extending specialized expertise into areas that have no resident psychiatrists. In this study, user perspectives and experiences of a pediatric telepsychiatry program serving rural communities in Ontario, Canada, were explored. Qualitative, exploratory methods were utilized because of the complex nature of mental health services needs and provision in rural communities. Focus groups with rural mental health service providers and interviews with family caregivers of children receiving a telepsychiatry consultation were conducted. The purpose of this research was to evaluate the benefits and limitations of providing pediatric psychiatric services via video-technology to inform future program development and health policy. Whereas participants in the study indicated that their experiences with the telepsychiatry service had been positive, the need for additional local services to support treatment recommendations was emphasized.

Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents

“…In the small, but growing, literature, parents (Elford et al 2001;Greenberg et al 2006;Myers et al 2008;Lau et al 2011;Reese et al 2013;Xie et al 2013;, adolescents (Myers et al 2006(Myers et al , 2007Boydell et al 2010) and their referring providers (Greenberg et al 2006;Myers et al 2008) have all reported high levels of satisfaction with care provided through TMH.…”

Teletherapy Delivery of Caregiver Behavior Training for Children with Attention-Deficit Hyperactivity Disorder

“…10 In the context of this article, teletherapy refers to the use of videoteleconferencing (VTC) to deliver interactively psychosocial interventions that are usually provided in-person. Multiple studies have reported the feasibility, acceptability, and tolerability of providing teletherapy to youth, [11][12][13][14][15][16] but few studies have examined the efficacy of teletherapy with caregivers and youth. Reese et al 17 used a pre-to post-intervention study design to examine the efficacy of a Group Triple P Positive Parenting Program (''Group Triple P'') for families with children diagnosed with attentiondeficit hyperactivity disorder (ADHD) and behavioral problems.…”

Masthead

“…The shortage of resources and support services in rural communities means that children requiring urgent attention are often placed in residential care outside of their home community (Sheldon-Keller et al 1996), compromising familiar psychosocial and cultural strengths and supports. Thus, the provision of psychiatric services to children and their families in rural and remote regions must address geographical barriers to access (Boydell et al 2006) and the distribution of scarce specialist resources, with attention to the cultural contexts of individual communities. Creative and innovative solutions responsive to these needs and challenges are required.…”

“…The TeleLink program of research has involved a series of studies including the development of a participatory approach to the design of an evaluation framework for pediatric telepsychiatry , family member and caregiver perspectives on pediatric telepsychiatry (Greenberg et al 2006), medical opinions on telepsychiatry (Greenberg et al 2003), an analysis of recommendations uptake made during telepsychiatry consultations (Boydell et al 2007) and the views of young people receiving consultations (Boydell et al 2010).…”