Telepsychiatry: effectiveness and feasibility

Abstract

Providing psychiatric services by real-time videoconferencing has been increasingly adopted as a method of reaching hard-to-serve populations since the early 1990s. As the field has expanded, a growing body of research has developed investigating both how telepsychiatry compares to in-person psychiatric care and how effectively telepsychiatry can be implemented in routine clinical care. A narrative review was performed to consider the evidence that telepsychiatry is feasible and effective across a variety of patient populations and clinical settings. There is a growing body of evidence investigating the efficacy of telepsychiatry when used for psychiatric assessment and treatment in the adult, child, and geriatric populations. Though studies vary in quality, they generally demonstrate that telepsychiatry is effective across multiple age groups and clinical settings. Telepsychiatry is generally well accepted by patients and clinicians and is feasible to implement, with the suggestion that some patients may actually prefer telepsychiatry to in-person treatment. Issues to consider in the implementation of telepsychiatry services include funding and reimbursement, medico-legal issues when provision crosses legislative boundaries, incorporation into existing health systems, and crosscultural considerations. Future directions for research and practice include a need for higher-quality efficacy studies, consideration of data security, increased attention to low-and middle-income countries, and the introduction of novel technological approaches.

Client Satisfaction and Experience With Telepsychiatry: Development and Validation of a Survey Using Clinical Quality Domains

“…Telepsychiatry is an increasingly common modality of mental health care that connects patients with psychiatrists at a distance via videoconference [ 1 ]. This mental health care delivery model is an effective clinical intervention that reduces geographical barriers and improves access to care in regions with limited resources [ 2 ].…”

Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review

“…While patient safety may have made it necessary to exclude those who may be most at risk or may not be able to consent, this makes it difficult to assess the mental health conditions for which virtual programs would be appropriate. Those that did include people experiencing more serious mental illnesses did suggest that virtual care may not be appropriate in these cases [ 76 , 77 ]. These hidden challenges may partially explain the “research to practice” gap that has been observed in the implementation of VMHS [ 78 – 80 ], and highlights that a one-size-fits-all approach to VMHS is unlikely to work in practice for various newcomer individuals and communities.…”

Telemental Health for the Homeless Population: Lessons Learned when Leveraging Care

“…It may come as surprising, but ongoing research supports that many homeless people have access to technology; thus, the concept of using technology to break-down access barriers is not a new concept [ 10 , 11 ]. Recent research supports that generally over half of the homeless population have a cell phone; however, in some studies, up to 90–100% of homeless sample groups had access to a cell phone or mobile device [ 12 ••].…”