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College Telepsychiatry Finally Catching Up—Slowly

The majority of American college students feel overwhelmed, depressed, and/or anxious, according to the latest American College Health Association survey. Unfortunately, many schools lack easy access to needed mental health care—if they have any at all. And this doesn’t even take into account the students’ hesitation to seek help due to the stigma often associated with mental illnesses. With the growth of telemedicine, telepsychiatry and telemental health present a viable solution that could overcome many of these challenges.

Already proven to be just as effective as in-person treatments for mental disorders, telepsychiatry offers several benefits for both students and universities. Students will likely value the privacy and easy access, making them more likely to seek treatment. Other issues may also be alleviated, such as lack of transportation, time off from work or class, or childcare, since telepsychiatry hours are not limited to business hours. Universities will appreciate the ability to expand mental health services without requiring large outlays for buildings and staff.

As universities contemplate adding a telepsychiatry program to their resources, they must navigate through evolving legal, regulatory, and financial matters, many of which depend on local or state jurisdictions. These include:

  • Licensing – Some states require doctors to have a telemedicine license in order to practice telemedicine, while other states require physicians to be board certified in their specialties before they can practice telemedicine. Some states allow a doctor licensed in another state to work with telemedicine patients within their borders, but other states require doctors to be licensed in the patient’s jurisdiction.
  • Reimbursement – Increasing numbers of private insurers are covering telemedicine, as are Medicare and Medicaid. However, over half of U.S. states lack laws governing coverage from commercial carriers. For students on their parents’ health plans, this could be a problem.
  • Security – The telemedicine platforms must comply with HIPAA; data must be encrypted, and the web link must be secure. For instance, Skype is not HIPAA-compliant.
  • Informed consent – The states vary widely in their requirements for ensuring that patients understand the potential risks and options regarding treatment, or in this case, telepsychiatry. In a few states, patients must also be informed on how to receive follow-up care.

Although telepsychiatry can be very effective for disorders such as depression, panic attacks, or anxiety, urgent and severe cases still need in-person intervention. This includes cases where people may be in danger of harming themselves or others.

As telemedicine becomes more available on college campuses, recommendation from trusted sources (word-of-mouth) will spread the word about the accessibility and effectiveness of telepsychiatry, believes Dr. Nadia Islam, clinical director of the University of Southern California (USC) Telehealth. USC has operated an online behavioral health clinic since 2012; during this time, the professors associated with the program have found that many of their clients have admitted either that they would never have sought therapy in the past, or that they tried therapy before but didn’t stick with it; most of these patients tend to shy away from traditional office buildings.

By using a smartphone, tablet, or computer—at home or a local mental health agency—patients can bring the doctor into their homes or dorm rooms, instead of traveling to the doctor. This enables the doctor to see more patients each day, since moving from one patient to the next is a simple matter of ending one call and picking up another. And when both patients and doctors benefit, this can only be a win-win solution for everyone involved.

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SUPPORT Act Eases Way for Telemedicine for Opioid Treatment

This week, on the one-year anniversary of declaring a national opioid public health emergency, President Trump signed into law the bipartisan “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act,” known as the “SUPPORT Act” for short. The goals of the legislation are to reduce “access to and the supply of opioids” and expand “access to prevention, treatment, and recovery services” through multiple angles, including via telemedicine for opioid treatment. Read more

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Using Addiction Telemedicine to Enhance Care

Every day, an estimated 115 people die from opioid abuse. To address the substance abuse epidemic—of opioids and other drugs–healthcare providers develop treatment plans that combine addiction control with behavioral and psychiatric care in a personalized package. Traditionally, treatment has centered around group therapy and in-office visits. Now, with the rise of telemedicine, providers can now work with patients at any time and place and can see first-hand aspects of the patient’s daily life. Read more

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Telehealth for Autism Shows Promise

Raising a child with autism can be challenging but rewarding, say their parents, but telemedicine is beginning to show itself to be a valuable tool. Whether it’s being used for remote assessments to diagnose autism or remote in-home therapy, telehealth for autism is currently being studied—and the preliminary results look promising. Read more

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Telemedicine Counseling for Genetic Testing Can Help Cancer Patients

For cancer patients, genetic counseling has become a standard of care at academic medical centers, but community-based medical centers often lack access to such resources. A new study, presented at the American Society of Clinical Oncology Annual Meeting this week, suggests that telemedicine counseling may help bridge that gap. Read more

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Home Telepsychiatry Reduces Anxiety, Saves Lives

Telemedicine has often been touted as a solution for remote regions with physician shortages, but one area of medicine is finding that telemedicine brings unexpected benefits, even if the patient lives right around the corner. Home telepsychiatry brings psychotherapy to the patient and meets the patient’s needs where he/she is. In the process, the physician can gain invaluable insight into the patient’s living situation—insight that might otherwise take weeks to uncover during in-office therapy sessions. For instance, a patient once complained of a cluttered home; she turned out to be a hoarder. The Department of Veterans Affairs (VA) has discovered especially intriguing results from using home telepsychiatry. Read more

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Telepsychiatry Program Combats School Violence

In the wake of the 2012 Sandy Hook Elementary School and Aurora, Colorado, theater shooting, a Texas telepsychiatry program was launched to help schoolchildren and teens deal with potential mental health issues that could lead to later violence or suicide. School violence may get all the attention, but suicide is the second most common cause of death among American teenagers. Both situations often stem from untreated mental or behavioral health issues among children and teenagers. In the years since those shootings, at-risk students at these Texas schools have received the psychiatric care they need and, in some cases, have even been removed from the school setting amidst safety concerns. Read more

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Year in Review: 2017 Telemedicine Legislation

Over the last year, 63 pieces of telemedicine legislation focusing on telemedicine were approved in 34 states, according to the Center for Connected Health Policy. These bills facilitated multi-state medical licenses, defined terminology, and established care standards, among other issues. Read more

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Telepsychiatry Extends Services Across Maine ERs

In recent years, increasing percentages of emergency department visits have required a psychiatric consult, but the number of psychiatric beds in emergency rooms has dropped. Amidst such a shortage, patients often end up with longer ER stays or are released without being treated. In Maine, St. Mary’s Regional Medical Center added emergency telepsychiatry services to their renovated ED in 2010; this allows them to link patients with a mental health professional around the clock. Read more

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Tele-Nicotine Can Help Patients Give Up Smoking

A recent pilot study found that telemedicine is effective at helping patients reduce or give up smoking. Dubbed “tele-nicotine”, the initiative at UT Southwestern’s Simmons Comprehensive Cancer Center focused on smokers in a homeless shelter. Over the course of the program, one quarter of the participants reported that they had stopped smoking entirely, and another 25 percent significantly reduced their nicotine usage. Read more