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.