Physician Resources

Patients in rural areas embracing telepsychiatry



NEW YORK – Remote psychiatric evaluations and consultations appear to be a good call for patients in rural or underserved areas, a telepsychiatrist says.

In a 32-month study, no significant differences were found in the number of adult and child/adolescent evaluations and follow-ups between face-to-face and telepsychiatric services, and both patients and psychiatrists appeared to be happy with the remote interviews, said Dr. Yilmaz Yildirim of the department of psychiatric medicine at East Carolina University in Greenville, N. C.

"The young population loved it," he said in a face-to-face interview.

Elderly patients, particularly women, were hesitant at first, but became "very comfortable" with telepsychiatry over time, he said at the annual meeting of the American Psychiatric Association.

Dr. Yildirim said he was so happy with the results himself that he closed his face-to-face clinic and now conducts all new evaluations and follow-up visits via remote telecommunications.

From August 2010 through March 2013, he provided mental health services in a community health clinic in New Bern, N.C., or via telepsychiatry services to rural counties in eastern North Carolina. The psychiatrist alternated face-to-face and telepsychiatry days.

Over the study period, there were 107 face-to-face clinic days with a total of 1,077 patients and 93 telepsychiatry clinic days seeing 890 patients.

Dr. Yildirim found that the mean number of patients seen per day was 9.79 for the remote visits, compared with 10.40 for face-to-face encounters, a difference that was not significant.

The mean number of new evaluations of adult patients per day was 1.06 for remote visits vs. 0.97 for face-to-face visits (no significant difference), and the mean number of daily adult follow-up visits also was similar at 3.52 and 3.64.

New evaluations of children per day averaged 0.78 for telepsychiatry and 0.93 for the face-to-face clinic, and the mean number of children seen for follow-up daily was identical to that of adult follow-up visits at 3.52 and 3.64, respectively.

The findings show that telepsychiatry is feasible as a means of providing mental health services to adults, children, and adolescents in areas where psychiatrists are few and far between. Telepsychiatry also could be used to provide some forms of therapy, Dr. Yildirim said.

"More telepsychiatry programs should be funded to provide mental health services in rural areas where access to mental health services is difficult," he wrote in a poster presentation.

"I think this would be very good for my country, Brazil, which has a shortage of psychiatrists all over. I think it’s an excellent solution" said Dr. Carlos Horta, a psychiatrist who practices in São Paulo, Brazil.

Dr. Horta was not involved in the study.

The research was supported by East Carolina University. Dr. Yildirim and Dr. Horta reported having no conflicts of interest.

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