Telepsychiatry Use in Rural Areas in the United States

2020 ◽  
Vol 13 (4) ◽  
pp. 1-13
Author(s):  
Alberto Coustasse ◽  
Morgan Ruley ◽  
Tonnie C. Mike ◽  
Briana M. Washington ◽  
Anna Robinson

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

Numerous challenges have limited access to mental health services in rural areas. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. Simultaneously, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices.


Author(s):  
Karan Chawla ◽  
Angesom Kibreab ◽  
Victor & Scott ◽  
Edward L. Lee ◽  
Farshad Aduli ◽  
...  

Objective: It is unknown whether patients’ ratings of the quality of healthcare services they receive truly correlate with the quality of care from their providers. Understanding this association can potentiate improvement in healthcare delivery. We evaluated the association between patients’ ratings of the quality of healthcare services received and uptake of colorectal cancer (CRC) screening. Subject and Methods: We used two iterations of the Health Information National Trends Survey (HINTS) of adults in the United States. HINTS 2007 (4,007 respondents; weighted population=75,397,128) evaluated whether respondents were up-to-date with CRC screening while HINTS 4 cycle 3 (1,562 respondents; weighted population=76,628,000) evaluated whether participants had ever received CRC screening in the past. All included respondents from both surveys were at least 50 years of age, had no history of CRC, and had rated the quality of healthcare services that they had received at their healthcare provider’s office in the previous 12 months. Results: HINTS 2007 data showed that respondents who rated their healthcare as good, or fair/poor were significantly less likely to be up to date with CRC screening compared to those who rated their healthcare as excellent. We found comparable results from analysis of HINTS 4 cycle 3 data with poorer uptake of CRC screening as the healthcare quality ratings of respondents’ reduced. Conclusion: Our study suggested that patients who reported receiving lower quality of healthcare services were less likely to have undergone and be compliant with CRC screening recommendations. It is important to pay close attention to patient feedback surveys in order to improve healthcare delivery.


2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.


2014 ◽  
Vol 1 (1) ◽  
pp. e5 ◽  
Author(s):  
John Torous ◽  
Steven Richard Chan ◽  
Shih Yee-Marie Tan ◽  
Jacob Behrens ◽  
Ian Mathew ◽  
...  

Background Despite growing interest in mobile mental health and utilization of smartphone technology to monitor psychiatric symptoms, there remains a lack of knowledge both regarding patient ownership of smartphones and their interest in using such to monitor their mental health. Objective To provide data on psychiatric outpatients’ prevalence of smartphone ownership and interest in using their smartphones to run applications to monitor their mental health. Methods We surveyed 320 psychiatric outpatients from four clinics around the United States in order to capture a geographically and socioeconomically diverse patient population. These comprised a state clinic in Massachusetts (n=108), a county clinic in California (n=56), a hybrid public and private clinic in Louisiana (n=50), and a private/university clinic in Wisconsin (n=106). Results Smartphone ownership and interest in utilizing such to monitor mental health varied by both clinic type and age with overall ownership of 62.5% (200/320), which is slightly higher than the average United States’ rate of ownership of 58% in January 2014. Overall patient interest in utilizing smartphones to monitor symptoms was 70.6% (226/320). Conclusions These results suggest that psychiatric outpatients are interested in using their smartphones to monitor their mental health and own the smartphones capable of running mental healthcare related mobile applications.


2021 ◽  
Author(s):  
Nurun Layla Chowdhury

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii440-iii440
Author(s):  
Kathy Riley

Abstract In the United States, more than 28,000 children and teenagers live with the diagnosis of a primary brain tumor (Porter, McCarthy, Freels, Kim, & Davis, 2010). In 2017, an estimated 4,820 new cases of childhood primary brain and other central nervous system tumors were expected to be diagnosed in children ages 0 – 19 in the United States (Central Brain Tumor Registry of the United States, 2017). Survivors suffer from lifelong side effects caused by their illness or by various treatments. Commonly identified late effects of treatment include a decline in intellectual functioning and processing speed, performance IQ deficits, memory deficits, psychological difficulties, deficits in adaptive functioning (daily life skills), and an overall decrease in health-related quality of life (Castellino, Ullrich, Whelen, & Lange, 2014). To address the ongoing challenges these survivors and their families face, the Pediatric Brain Tumor Foundation (PBTF) met extensively with working groups comprised of survivors and caregivers to develop the outline for a comprehensive Survivorship Resource Guidebook. In 2019, the PBTF published the guidebook which categorizes survivor and caregiver needs into three primary areas: physical and mental health, quality of life, and working the system. Expert authors included survivors and caregivers themselves in addition to medical and mental health professionals. Key outcomes discovered during the creation and production of this resource highlight how caregivers, survivors and professionals can collaborate to provide needed information and practical help to one segment of the pediatric cancer population who experience profound morbidities as a result of their diagnosis and treatment.


2017 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This chapter contains 56 references.


2015 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This chapter contains 56 references.


Author(s):  
Elizabeth M. Moore ◽  
Theresa H. Cheng ◽  
Roya Ijadi-Maghsoodi ◽  
Lillian Gelberg

An estimated 100 million people globally suffer from absolute homelessness. The estimated number of people who are homeless in the United States at any given point in time is about 550,000. Mortality and disease severity of people who are homeless far exceed those of the general population because of extreme poverty, delays in seeking medical care, nonadherence to therapy, substance use disorders, and psychological impairment. Many of their health problems, such as infections due to crowded living conditions in shelters, hypothermia from exposure to extreme cold, and malnutrition due to limited access to food and cooking facilities are a direct result of homelessness. This chapter addresses in detail infectious diseases, substance abuse, obesity, mental health problems, and causes of death in this population. It also addresses access to and use of healthcare services. It addresses the roots of and underlying issues related to these problems. Finally, it addresses what needs to be done.


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