In an article published in Psychiatric Services, Linda Godleski, M.D., Adam Darkins, M.D., M.P.H. & John Peters, M.S. reported clinical outcomes of telemental health in April of 2012. Conducted at the Veteran’s Administration (VA), the study compared inpatient psychiatric admissions and days of psychiatric hospitalization for an average of six months before and after telemental health services. Their sample was 98,609 patients who participated in remote clinical videoconferencing.
The report’s conclusions state, “Between 2006 and 2010, psychiatric admissions of telemental health patients decreased by an average of 24.2% (annual range 16.3%-38.7%), and the patients’ days of hospitalization decreased by an average of 26.6% (annual range 16.5%-43.5%). The number of admissions and the days of hospitalization decreased for both men and women and in 83.3% of the age groups.”
A Clinical Psychiatry News article summarized Dr. Godleski’s presentation of this groundbreaking study to the American Psychiatric Association last weekend. It discussed the varied services now offered by the VA in over 530 sites.
It mentioned that the VA offers services from psychiatrists, psychologists, advanced-practice nurse specialists, physician assistants, social workers, registered nurses, substance abuse professionals, vocational rehabilitation specialists, and their trainees.
It further explained that the VA offers individual therapy, couples therapy, group therapy, family therapy, behavior therapy, psychological testing and medication management. Disorders treated range from affective disorders, anxiety disorders, post traumatic stress disorder and psychotic disorders, to substance abuse disorders.
It may be worth noting that the Veteran’s Administration offers many protections to both their practitioners and their patients. Those same protections are not available to the average mental health professional working from their desktop to reach patients or clients located in unsupervised settings, such as a patient’s home. Research into these unsupervised settings and how to handle issues such as emergencies across geographic distances are still under examination.
Clinicians interested in using telehealth strategies in clinics, small groups or individual practice are encouraged to obtain adequate professional training and proceed cautiously.