Telepsychiatry: Help Is Just A Click Away


SEATTLE, Wash. (Ivanhoe Newswire) — It’s often difficult for folks who live in rural areas to get access to a psychiatrist. But now, the psychiatrist is coming to them, in a way. The University of Washington program is set up in a collaborative care system that includes a primary care doctor and a counselor in rural areas, and a psychiatrist who checks in by webcam.

Anna Ratzliff, MD, PhD, Associate Professor, Psychiatry & Behavioral Sciences, University of Washington School of Medicine, is in her weekly consultation with behavioral healthcare manager Wayne Pollard. Wayne works at a clinic in Dayton, 300 miles away. There’s no psychiatrist there, but now, residents can get help from a team at the University of Washington.

“There’s a building interest for folks to be able to have the experts there at U dub take a look at their cases and take a look at their symptoms and try and come up with a medication regimen that’s going to help them feel better in the end,” explained Pollard.

Dr. Ratzliff says telepsychiatry gets advanced mental healthcare to people in remote areas.

“When we use telepsychiatry, we can get out to those small places like Dayton and help impact the healthcare for those 4,000 people that before telepsychiatry didn’t really have access to a psychiatrist at all,” explains Dr. Ratzliff.

It’s part of a collaborative care model. The psychiatrist makes recommendations to the healthcare worker, who passes the information on to the local doctor, who sees the patient at their clinic.

“Clinics that are implementing collaborative care typically are twice as effective at treating their patients to actually getting patients to respond to treatment,” continued Dr. Ratzliff.

Ian Bennett, MD, PhD, Professor, Family Medicine, University of Washington School of Medicine, treats a lot of pregnant women and new moms with depression. He says a telepsychiatrist makes his work as a physician easier.

“Linking those all together means that the patient walks out and has an experience with a health system that’s much more satisfying and effective. They are more functional at the end of the day,” stated Dr. Bennett.

“I feel blessed. The clinic feels blessed, and I know the patients are going to benefit here in the end,” Pollard shared.

University of Washington’s telepsychiatry team reviews seven to ten cases an hour, most of them being depression or anxiety. The telepsychiatry program has served 50,000 in 100 clinics in the last ten years. Most states are doing some of this work and it is now paid for by medicare.

Contributors to this news report include: Wendy Chioji, Field Producer; Roque Correa, Editor; and Rusty Reed, Videographer.

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REPORT #2585

BACKGROUND: According to the U.S. Centers for Disease Control and Prevention, 25% of American adults suffer from a mental illness, and almost half will experience one at some point in their life. Despite popular narratives about overdiagnosis and overmedication, these figures indicate that too few people are being properly treated for their illnesses. Telepsychiatry is an innovative practice in healthcare that applies telemedicine to the field of psychiatry. It generally refers to the delivery of psychiatric assessment and care via telecommunications technology, usually videoconferencing. There’s no question that a lack of access to proper psychiatric care is one of the biggest struggles of the American public health system. While psychiatry is traditionally one of the branches of medicine least affected by technological change, recent advances in videoconferencing technology have proven effective in bringing professional mental health care to underserved populations. This practice is one of the most promising developments in the fight to provide more patient-centered, affordable and effective interventions for individuals who need psychiatric care.


A PATIENT’S EXPERIENCE: In most cases, the process of getting help changes little. Patients first visit their primary care provider or contact a mental health clinic in their area to discuss their concerns. The individual will then be provided with a referral to see a psychiatrist or mental health specialist, and the clinic will arrange a time for an appointment. When the time comes, the patient will visit their regular local care center, where they will be taken to a private room for a one-on-one videoconference with the specialist. The content of the appointment will be exactly the same as if it were taking place in person. Doctors can discuss the issue in detail, make a treatment plan and even prescribe medicine through telepsychiatry. Any follow-up appointments or further referrals can be conducted much in the same way, saving the patient considerable travel time and related expenses.


GOING BEYOND BOUNDARIES: While the nation struggles with an overall shortage of mental health providers, so do prisons, where the demand for mental healthcare is stunningly high: of the 2.2 million people currently in prison or jail in the United States, 26% of those in jail and 14% of those in prison met the Bureau of Justice Statistics “threshold for serious psychological distress,” compared to just 5% in the general population. “There’s a huge need inside for mental health support,” said Brad Brockmann, executive director of the Center for Prisoner Health and Human Rights. “Without telemedicine, we’d really be hurting,” said Dr. Joseph Penn, director of mental health services for UTMB Correctional Managed Care. Most of the telepsychiatry offered to Texas inmates is aimed less at therapy and more at making diagnoses and managing medications. “It really improves access to care, continuity of care, and it gives us so many efficiencies to see patients in a more timely manner,” Penn said. Getting prisoners to providers in person raises a slew of problems. For one, there’s transportation. “We’re dealing with a potentially dangerous offender population,” Penn said. There’s the risk of escape and assault. By doing telepsychiatry, there is an increase in public safety. Indeed, it’s not just prisoners being treated for mental illness who feel a stigma, it’s also their providers. “A lot of practices don’t want our prisoners because they’re worried about the danger, and we’re all about striving for efficiency,” concluded Penn.


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