WASHINGTON, D.C. – Two studies released today in the journal Psychiatric Services add to the growing evidence of telepsychiatry’s contribution to improved mental health care. One study examined the use of telepsychiatry in emergency departments nationwide and a second looked at the use of telepsychiatry to improve screening, diagnosis and treatment of pregnancy-related depression.
In the first study, researchers examined data from two nationally representative surveys of emergency departments. In the first, 20% of more than 4,500 respondents reported using telepsychiatry services for patients. In the second more targeted survey, among the 95 emergency departments confirming telepsychiatry use, 59% reported having no other emergency psychiatric services. The authors conclude that telepsychiatry is filling a critical need in emergency departments, particularly in both rural areas and in high-volume emergency departments.
Many people experiencing a mental health crisis have nowhere to turn except emergency departments. Approximately one in eight visits to emergency departments involves mental and substance use disorders, according to the Agency for Healthcare Research and Quality.
In the national surveys, emergency departments were more likely to use telepsychiatry if they had higher visit volumes or were in rural areas. Most emergency departments in the surveys received telepsychiatry services at least six times a week; about one quarter received services at least once a day. Most had access to telepsychiatry 24 hours a day, 365 days a year. The telepsychiatry services were most frequently used for admission or discharge decisions and to coordinate transfers.
Another study in the journal looked at the use of telepsychiatry in an integrated care setting to help identify and treat pregnancy-related depression. Perinatal depression, during pregnancy or up to 1 year postpartum, is the most common complication of pregnancy. Integrated care involves behavioral health treatment in primary care or other medical outpatient settings, such as an OB-GYN clinic.
Researchers piloted a model of telepsychiatry-enabled integrated care for pregnant and postpartum women at a women’s clinic serving an at-risk, socio-economically disadvantaged population. The program involved universal depression screening, a virtually embedded behavioral health clinician and telepsychiatry services. The behavioral health clinician, via video conferencing, oversaw screening of all perinatal patients, provided brief intervention, made referrals and supported coordination of virtual psychiatric consultation.
Over 14 months, more than 700 patients were screened for depression and 19% were referred to behavioral health services. Of those, nearly all (96%) engaged in behavioral health treatment, far more than national estimates of treatment engagement of 60% or less.
One unanticipated result of the program was that because all patients were being screened for depression, “the screening process helped normalize depression and behavioral health as a topic,” making it more comfortable for providers to talk about problems or concerns with their patients. Providers reported that the presence of the behavioral health program increased their confidence in addressing and managing behavioral health symptoms.
Overall the telepsychiatry pregnancy-related depression program was associated with improved screening and diagnosis and improved patient outcomes. The authors conclude their results add to the “growing body of evidence for the use of telepsychiatry-supported integrated care across diverse clinical settings and patient populations.”
American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,800 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.