Telepsychiatry: Learn What It Is, its Benefits, Applications & How To Access

The History of Technology and Telehealth at Work

Before telepsychiatry even existed, telehealth was around since the early 1940’s.

The world’s first example of an electronic medical record transfer occurred in Pennsylvania, when radiology images were sent 24 miles between two townships via telephone lines. Later, in the 1950’s, a Canadian doctor built upon this technology, developing a teleradiology system that was used around Montreal.

In 1959, the University of Nebraska established a two-way television setup to transmit information to medical students across campus. 5 years later, they partnered with a state hospital to perform video consultations.

Early in the 1960’s, telemedicine started to appear in urban communities. And in 1967, the University of Miami School of Medicine partnered with a local fire department to transmit electrocardiographic rhythms over radio to Jackson Memorial Hospital in rescue situations. Additionally, the National Aeronautics and Space Administration (NASA) also tapped into telemedicine. In fact, in the 60’s they began performing physiologic monitoring over a distance. They later further this technology with a pilot with the Papago Indians and started a new program, Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) in the early 1970’s.

The purpose of telehealth is to improve access and quality of health care across many geographic and economic spectrums. Today, telehealth serves rural communities that don’t have access to local physicians, millions of individuals across the nation as well as healthcare providers.

In 2020, thanks to the COVID-19 pandemic, telehealth became a necessity worldwide.

Telemedicine vs. Telepsychiatry

Telemedicine is the process of providing health care from a distance with the help of video technology.

Telepsychiatry is a branch of telemedicine involving a variety of services such as psychiatric evaluations, therapy (individual, group, family etc.), patient education and medication management, according to the American Psychiatry Association.

Today, telepsychiatry is used by psychiatrists to interact and engage with patients. Additionally, it is also used by primary care providers who bring in psychiatrists for their expertise, support, and assistance with mental care consultations. Overall, telepsychiatry allows mental health care to be delivered in a live and interactive session. It also involves recording medical information such as images, videos etc. and sending them to a distant site for later review.

Benefits of Telepsychiatry

As briefly discussed, telepsychiatry is beneficial to both patients and psychiatrists.

Starting with patients, telepsychiatry has helped meet patient needs (of all ages – including children, adolescents, and adults) looking for convenient, affordable, and accessible mental health services. Other patient benefits according to the American Psychiatric Association include:

• Gaining access to healthcare providers (psychiatrists in this case)
• Bringing care to the patient’s location (including follow-ups)
• Integrating both behavioral health and primary care
• Reducing emergency room trips/visits
• Reducing delay in care
• Reducing the need for time off work, childcare services, etc. to access appointments far away
• Eliminating transportation barriers
• Reducing the barrier of stigma and more

Recent studies have shown that most people are comfortable with speaking to a person via a screen. They are more relaxed and willing to open-up from the comfort of their home or another convenient location.

Telepsychiatry has overall created a sense of safety, security, and privacy for many patients. Satisfaction and overall experience are high among patients of all age groups. As more and more people tap into video communication (i.e., facetime, zoom, google hangouts etc.), telepsychiatry is likely to become less of a problem for future patients. Thus far, telepsychiatry has been found especially effective for patients suffering with PTSD, depression, ADHD, anxiety, eating disorders, substance abuse and schizophrenia.

For psychiatrists, telepsychiatry has given them the opportunity to expand and treat more patients living in rural and other isolated geographical areas. Keep in mind that psychiatrists must be licensed in the states where patients they are working with are located.

Where Is Telepsychiatry Used?

Telepsychiatry is used in various settings. Everything from hospitals, private practice, outpatient clinics, correctional facilities, nursing homes, schools and more.

According to the Agency for Healthcare Research and Quality, an estimated 1 in 8 emergency room visits involves a mental health and/or substance use condition. Many times, emergency rooms are not fully equipped to treat individuals with serious mental health issues, nor do they have a psychiatrist or other type of mental health clinician available to assess and treat them. In fact, approximately 17% of emergency rooms have a psychiatrist on call for psychiatric emergencies.

Another example of where telepsychiatry is being used is in nursing homes. In nursing homes, telepsychiatry helps provide ongoing psychiatry evaluations, care, and emergency crisis intervention when difficult to find a local psychiatrist to assist.

Lastly, telepsychiatry is also being used by correctional facilities in many states to provide ongoing mental health care to inmates.

Getting started with telepsychiatry is simple.

First, individuals need to contact their regular psychiatrist and/or therapist to see if they offer telepsychiatry services. If they do, great. If they don’t, reach out to a local health clinic or your primary care doctor to obtain a referral to see a psychiatrist and/or therapist. From there, individuals can call to schedule their initial telepsychiatry appointment after they’ve checked with their insurance provider if telehealth is covered.

Like all in-person health care appointments, once your telepsychiatry appointment has been scheduled, individuals should prepare for the visit by obtaining any relevant records/information, prescriptions, and a list of questions they’d like to address. Typically, psychiatrists and therapists will have someone from their team send out the video conferencing information to enter the appointment.

Whether you have an in-person or telepsychiatry appointment, just know they both follow the same guidelines and format. Your psychiatrist and/or a therapist will discuss relevant issues, goals, treatment plans, etc. They can also prescribe medication, provide referrals for additional services, and can also schedule follow-up appointments as needed.

Insurance Coverage

Before booking a telepsychiatry appointment, it is recommended that individuals check with their insurance provider to see if these services are covered.

According to the American Psychiatric Association:

• 43 states including the District of Columbia have laws that govern private payer reimbursement for telehealth services.
• 50 states including Washington D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service and only 16 state Medicaid programs reimburse for store-and-forward services (also known as asynchronous telemedicine).

When it comes it Medicare, telepsychiatry services will be reimbursed if the community is considered rural. Individuals will then be required to report to an originating site unless that individual has a substance use disorder. If so, Medicare will also cover any co-occurring diagnosis under the Support Act. During a public health emergency, Medicare beneficiaries regardless of geographic location, may be seen in their home.

Medicaid policies, rules and laws are continuing to change as it relates to telehealth. Make sure to stay on top of these changes to see how it affects your coverage.

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