Telepsychiatry the Newest Mental Health Aid

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University of California at Davis investigators found psychiatrists could diagnose and treat individuals after viewing videotaped interviews that are sent via telecommunications lines.

The approach that psychiatrists want to use on mental health is called asynchronous telepsychiatry. Basically it uses “store-and-forward technology in which medical information is retrieved, stored and transmitted for later review using e-mail or Web applications.

This technology has been used at length for specialties such as dermatology, with photos of skin conditions sent to dermatologists, or X-rays sent to radiologists for assessment. The study is the first to examine store-and-forward technology for psychiatry, said Peter Yellowlees, professor of psychiatry and behavioral sciences at UC-Davis and the study’s lead author.

Telepsychiatry is Feasible

“A Feasibility Study of the Use of Asynchronous Telepsychiatry for Psychiatric Consultations” is published in the August issue of the journal Psychiatric Services.

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“We’ve demonstrated that this approach is feasible and very efficient,” said Yellowlees, who is an internationally recognized expert in telepsychiatry.“Using store-and-forward technology allows us to provide opinions to primary-care doctors much more quickly than would usually be the case.”

Researcher Alberto Odor, associate adjunct professor of anesthesiology and pain medicine, did the study by conducting 20- to 30-minute “structured” videotaped interviews at a community-based primary care clinic. These videos uploaded to a Web-based telepsychiatry consultation record. Yellowlees and Donald Hilty, professor of psychiatry and behavioral sciences, reviewed the videotapes and provided psychiatric evaluations to the patients’ community-based primary care physicians.

It appeared that fifty-one percent of patients received diagnoses of mood disorders, 19 percent received diagnoses of substance use disorders, 32 percent received diagnoses of anxiety disorders and 5 percent received other mental health diagnoses which included kleptomania and schizophrenia.

The consulting psychiatrists now can provide feedback to referring physicians within 24 hours if it were to become a regular service. Telepsychiatry is the newest mental health aid, should not take the place of face-to-face psychiatric evaluations and is not suitable for patients with urgent psychiatric conditions, he said.

“There is a substantial shortage of psychiatrists,” Yellowlees said. “Asynchronous telepsychiatry would allow us to have better access to information about patients being referred by primary providers and to provide more comprehensive opinions.”

“This approach could be used by the military and in many different rural and metropolitan settings. It signals the beginning of the true multimedia electronic medical record with clinical video recordings becoming part of the data set,” stated Yellowlees.

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