Telemental Health: Regulations Make Room for New Programs

Telepsychiatry began as a way to treat NASA astronauts and Native Americans on reservations, but with the expansion of broadband and mobile technologies, such as tablets and smartphones, the practice is expanding in rural areas where treatment is scarce — and it’s proving to be a lifeline for physicians to treat behavioral health issues.

While telemedicine isn’t quite taking off with patients and providers in all fields, telemedicine to treat behavioral health can fill gaps in areas where provider shortages prevail. And shortages do prevail, with the U.S. meeting less than half of its needs for mental health professionals across the country, according to the Department of Health & Human Services.

One example is Peter Yellowlees, a professor at UC Davis who uses video conferencing tech to hold telepsychiatry clinics on Indian Health Reservations, MedCity News reports. He believes the practice is expanding as the cost of video conferencing technology drops.

“There’s a whole range of areas where we can provide a better standard of care using video than we can in person,” Yellowlees said.

State Legislation Expands Behavioral Telehealth Access

Barriers remain to implementing telemedicine in the healthcare industry, mainly with regulatory issues. But with the aim to expand care to those in rural areas, several states began 2017 by working to expand the regulatory infrastructure for mental telehealth.

Delegates in West Virginia, for example, approved a telehealth bill in early March, voting to expand access to mental and behavioral medications via video calls and other technologies. The expansion will mainly look to expand services that help diagnose and treat children.

“We have a tremendous problem with access to mental health providers, particularly for our pediatric population," Cabell County Delegate Matthew Rohrbach told West Virginia Public Broadcasting. "ADHD is the main thing that [new telemedicine laws are] going to seek to close, so kids that have ADHD can be treated via telehealth to get their Adderall and other prescriptions … this is really to extend for our mental health providers a way to service our clients in rural areas.”

Utah has also made moves to expand mental health care with telemedicine technologies. A bill that has passed both houses of the Utah legislator, now awaiting the governor’s signature, enables mental health services via telehealth technologies, according to the National Law Review.

Several states are also moving to halt or strike down laws that limit telemedicine services. Alabama’s medical board recently halted a law requiring first-time visits between a patient and physician to be in-person, according to the American Telemedicine Association. Texas, in which almost 80 percent of counties have mental health professional shortages, recently rejected a similar law.

Health Providers Expand Telemedicine Programs

Providers are stepping up to fill the gaps as regulation allows. In Minnesota, the Mayo Clinic Health System in the city of Albert Lea has launched a telemedicine program for patients to communicate with psychiatrists and psychologists 24/7 from the emergency room, the Austin Daily Herald reports.

Bo Madsen, the medical director of emergency medicine at Mayo throughout southeastern Minnesota, told the paper that the telehealth program allows many patients to access care in areas where several smaller hospitals aren’t able to have psychiatrists and psychologists on hand; this eliminates patients having to wait or travel.

“Instead of sitting in an emergency department for potentially 72 hours … I think people appreciate that we’re doing things immediately,” Madsen said, noting that services can include assessment, treatment and placement for outpatient or inpatient behavioral health needs.

Telemedicine Tech Brings Mental Health Care to Veterans

The Veterans Affairs Department is also using telemedicine to augment mental health care for veterans, according to the VA. While the department has opened outpatient clinics across the country with the aim of expanding care, they often call in experts via their Clinical Video Telehealth (CVT) system to augment the mental health care they are able to provide in person.

“For many veterans travel to the medical center can be a very complicated and sometimes arduous task, particularly if the veteran lives in a very remote or rural area, an area with sometimes severe weather, or even an urban area where congestion and traffic makes travel difficult. Some injuries such as traumatic brain injury or spinal cord injury further complicate travel. Travel time is time away from the veteran's work or family,” the VA’s website notes.

They are able to remedy these issues by calling on the CVT technology, allowing professionals to make diagnoses, as well as manage and provide care via the telemedicine system.