Thursday, May 08, 2014

Telepsychiatry is working in the Carolinas, where many rural counties lack mental-health providers

Photo: N.C. Center for Public Policy Research
Finding mental health care in rural America is often a struggle for patients, with 25 percent of Idaho's residents lacking access to a psychologist or psychiatrist. The problem is just as bad in North Carolina, where 58 of the state's 100 counties have been "designated as Health Professional Shortage Areas because they do not have enough mental health providers," according to the North Carolina Center for Public Policy Research.

But in North Carolina rural residents are utilizing telepsychiatry to get the help they need, reports NPR. Psychiatrist Dr. Sy Atezaz Saeed told the radio network, "When you ask patients about this experience, most of them will tell you that after a few minutes of some hesitation, they even forget that they are talking to the doctor via this monitors."

A study by the NCCPPR found that the method works, stating that patients who use telepsychiatry "spend less time waiting in hospital emergency rooms and have a lower likelihood of returning for treatment. The study also found fewer involuntary commitments to state psychiatric hospitals and high satisfaction for telepsychiatry patients."

This is good news for a state where 28 counties don't have a psychiatrist and 18 counties only have one, the report states. It's even worse for children, with 70 counties lacking a child psychiatrist. Only six counties have a geriatric psychiatrist, five have an addiction psychiatrist and only 13 have physicians that specialize in addiction and chemical dependency.

The North Carolina model was based on success in South Carolina, where the average number of patients treated using telepsychiatry grew from 2010 to 2013 from 8.7 to 12.3 per day and "the length of stay in emergency departments while waiting for treatment decreased from 48-72 hours in 2010 to less than six hours in 2013," the report states.

Research in northeastern North Carolina, which has 10 of the 28 counties without a psychiatrist, found that through telepsychiatry "the length of stay in the emergency rooms for patients waiting to be discharged to inpatient treatment declined from 48 hours to 22.5 hours," the report says. The number of patients who had to return for treatment within 30 days decreased from 20 percent to 8 percent. Involuntary commitments to local or state psychiatric hospitals decreased by 33 percent. Re-admissions to psychiatric hospitals declined, and 88 percent of patients said they were satisfied with the telepsychiatry services.

The state legislature appropriated $2 million for fiscal 2013-14 and $2 million for 2014-15 to implement a new statewide telepsychiatry system; 49 of the state's 108 hospitals are participating, and the remaining hospitals are expected to join by July 2015. Gov. Pat McCrory said, "No matter where you live in North Carolina, you will soon have better access to mental health providers with the expansion of telepsychiatry across our state. Technology will help us connect people with appropriate treatment programs so patients can avoid long waits in the emergency room. North Carolina can be a national leader with this program." (Read more)

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