When Psychiatric Care Is Far Away, Telehealth Fills the Gap

February 11, 2022

Telehealth took off during the COVID-19 pandemic, and a new study shows even people with serious mental health conditions can benefit from online appointments.

The findings are good news for rural folks who live miles away from psychiatrists and psychologists.

"This study showed that patients with multiple psychiatric conditions and who also struggle with several chronic physical health problems can engage well in mental health treatment with their primary care doctors or remote mental health specialists," said study co-author Dr. Jennifer Severe, an assistant professor of psychiatry at the University of Michigan, in Ann Arbor.

But it also showed that patients with drug problems and manic symptoms from bipolar disorder may need additional support to get started on psychotherapy or to stay with it, the researchers said.

The study was conducted before the COVID-19 pandemic, to see if people living far away from mental health care providers could benefit from telehealth services. The work was timely, given that many health care visits have moved online because of the pandemic.

The researchers looked at just over 1,000 people with post-traumatic stress disorder, bipolar disorder or both conditions who used two types of telehealth at 24 safety-net clinics in Michigan, Washington and Arkansas.

Two-thirds of the patients had incomes or disabilities that made them eligible for Medicaid, and half were unemployed.

Patients were divided into two groups. Half engaged with a far-away psychiatrist and psychologist, while the other half mostly connected with team members at the local primary care clinic who received guidance from a distant psychiatrist.

In both groups, most patients responded well to medication and/or psychotherapy (also known as "talk therapy"), but there was one major difference.

The patients who received psychotherapy from a specially trained nurse or social worker at their local clinic completed 60% more such sessions than those who received psychotherapy from a psychologist via video, the findings showed.

Regular in-person contact with nurses or social workers checking on patients' other health needs may have been a contributing factor in that difference, according to the study.

"The study started at a time where clinicians had reservations about treating psychiatrically complex patients with telehealth or integrated care models. Understandably, engagement in care was one of the many concerns," Severe said in a university news release.

The findings were published online recently in the Journal of General Internal Medicine.

More information

For more on "telemental" health, go to the U.S. National Institute of Mental Health.

SOURCE: University of Michigan, news release, Feb. 2, 2022

Bipolar Affective Disorder Anxiety Psychology / Mental Health: Misc.Depression Post-Traumatic Stress Disorder