Telemental Health Technology in Deaf and General Mental-Health Services: Access and Use

Abstract

Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was associated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

Current directions in videoconferencing tele-mental health research.

“…Tele‐mental health service or program descriptions have been published from around the world, although such reports from underdeveloped nations are rare. These service or program descriptions include reports in the areas of child and adolescent mental health service delivery (Browne, Reilly, & Bradley, 2006; Nelson, Barnard, & Cain, 2003, 2006; Ryan, Stathis, Smith, Best, & Wootton, 2005; Savin, Garry, Zuccaro, & Novins, 2006; Staller, 2006); family therapy (Bischoff, Hollist, Smith, & Flack, 2004; Hill et al., 2004; Keilman, 2005; Kuulasmaa et al., 2004); mental health services for the deaf (Austen & McGrath, 2006b; Lopez et al, 2004); substance use (Frueh, Henderson, & Myrick, 2005); cognitive‐behavior therapy (CBT) for mood and anxiety disorders (Frueh, Monnier, Grubaugh, et al, 2007; Griffiths, Blignault, & Yellowlees, 2006; Himle et al., 2006); cancer patients with adjustment disorder (Cluver, Schuyler, Frueh, Brescia, & Arana, 2005; Shepherd et al, 2006); mental health practitioner training and supervision (Ekblad et al., 2004; Fahey, Day, & Gelber, 2003; Heckner & Giard, 2005; Hilty, Alverson, et al., 2006; Meyer et al, 2005; Walter, Rosenquist, & Bawtinhimer, 2004); psychiatric consultation‐liaison services (Hilty, Yellowlees, Cobb, et al., 2006; Hockey, Yellowlees, & Murphy, 2004); deployed military personnel (Grady & Melcer, 2005; Hill et al., 2004; Neufeld, Yellowlees, Hilty, Cobb, & Bourgeois, 2007); and diagnosis/assessment (Hildebrand, Chow, Williams, Nelson, & Wass, 2004; Kobak, 2004; Shore, Hilty, & Yellowlees, 2007).…”

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

“…Deaf people who live in rural environments are especially affected by this problem. Deaf adults and deaf children who receive mental health services should work with competent providers who are able to communicate effectively [ 51 , 52 ]. Simply using an interpreter in therapy sessions is not an optimal accommodation, though it may be the only option available when there are no culturally competent clinicians nearby.…”

“…Deaf individuals typically already have technological expertise with videoconferencing because they often use videophones as their telephone [51] . Therefore, pilot telepsychiatry programs for deaf populations were briefly tried in North and South Carolina in 1997 [ 53 , 55 ] with an existing program in Illinois in 2014 [54] .…”

“…Thus, there are few research findings comparing the effectiveness of telepsychiatry health services [52] . In one study cited by Gournaris (2009), findings suggested that there is no significant different between face-to-face therapy and videoconferencing with deaf adults receiving treatment but further research was required [51] .…”

Message Transmission Efficiency Through Five Telecommunication Technologies for Signing Deaf Users

“…For example, in a case report, a patient successfully communicated with a telepsychiatrist with an ASL interpreter, and her psychiatric symptoms improved (Lopez et al, 2004). In a survey conducted by postal questionnaire (N = 134), deaf staff within deaf services appeared significantly more confident about videophone use (Austen & McGrath, 2006).…”