Mental Health

The types of telemental health services most frequently provided are those that replicate traditional mental health care. When scarce mental health care is delivered into remote areas of need, telemental health is "the next best thing to being there." In some situations, telemental health may be superior to face-to-face contact.

For example, telemental health allows a psychiatrist to observe a patient close up, without invading his or her personal space. This makes it easier to examine a patient for side effects of psychotropic medications. Also, in clinical interventions that focus on confronting an individual's destructive behaviors, or on revealing past abuse, telemental health creates a comfort zone for some consumers.

There is no mental health service currently being offered face-to-face that can't be delivered via telemental health. Some specific examples follow. However, like traditional mental health services, telemental health services may not be effective for every consumer. For example, a consumer with serious mental illness such as paranoid delusions focused on electronic monitoring, will need to be observed closely for his/her reaction to the use of this new tool.

Professional staff at distant service locations can use a telemental health network to take social histories, conduct mental status examinations, and determine an individual's eligibility for ongoing services. The individual need only travel to a local site connected to the network.

Rural service sites that do not have local therapists available can offer individual, marital, family, and group psychotherapy and counseling over a telemental health network. This is especially useful when individuals need a therapist who serves special needs, such as those of adult survivors of childhood sexual abuse or Vietnam veterans.

Telemental health can bring the psychiatric emergency room to the consumer. A rural mental health consumer in crisis can be examined by a distant psychiatrist over a telemental health network. The psychiatrist can assess the need for medication changes and inpatient care. Community mental health staff and family members can participate, as well.

Telemental health has enormous potential in the area of medication management. Most notably, the same psychiatrist who treats an individual as an inpatient, or initially on an in-person outpatient basis, can provide long-term follow-up in the client's home community. The ongoing psychiatrist/consumer bond, maintained through telemental health, can eliminate unnecessary medication changes, reduce the need for readmission, and shorten the length of inpatient stays. Also, the treating psychiatrist can monitor a client's use of a new atypical antipsychotic medication, thereby ensuring equal access in rural areas to the most effective treatments.

Finally, telemental health extends the service range of nurse practitioners, physician assistants, and psychiatric clinical nurse specialists who serve rural areas and practice in consultation with psychiatrists to provide medication review clinics and manage difficult cases.