What is teleBehavioralHealth?

TeleBehavioralHealth, also known as telePsychiatry, and teleMentalHealth, is virtual care for mental health and substance abuse patients.

Remote clinicians use telecommunications technology like videoconferencing to make it possible for patients to seek ongoing mental health support with privacy and convenience. Appointments can be scheduled in advance, just like in-person care.

How does teleBehavioralHealth work?

Just like most telemedicine visits, teleBehavioralHealth starts with a patient or their healthcare provider requesting a consultation. In emergency cases, it may be a nurse or physician in the emergency department, or on the med/surg floors.  For outpatient care, it may be a healthcare provider in a physician’s office or clinic.

Once the consultation is requested, the mental health professional logs on to a videoconference with the patient, who is in a private location. This could be a room in the hospital, or in a physician’s office or clinic. It could even be in the patient’s home.

The teleBehavioralHealth professional establishes the purpose of the virtual medical consultation and evaluates the patient. Sessions are typically 45 minutes to an hour, similar to in-person care. At the end of the consultation, the mental health professional provides feedback to the patient on follow up care, as well as documents the visit. In the case of emergency telePsychiatry, the psychiatrist would provide documentation and feedback to the hospital staff for additional testing, treatment, and/or follow up care.

Why is the use of teleBehavioralHealth growing?

There is a shortage of mental health professionals. The United States has an average of 30.0 psychologists and 15.6 psychiatrists per 100,000 people, and they are not evenly distributed throughout the country. There are areas in which the ratio of mental health professionals to residents is smaller than 1 per 30,000 people. There are entire counties that don’t have any psychiatrists.

The Substance Abuse and Mental Health Services estimates that in five years, the U.S. will have shortages of:

  • 10,470 Marriage and family therapists
  • 15,400 Psychiatrists
  • 26,930 Mental health counselors
  • 48,540 Social Workers
  • 57,490 Psychologists
  • 78,050 School counselors

More mental health professionals are retiring than are being replaced by younger entrants. At the same time, the population is growing, and statistics point to more people seeking mental health support in the future.

Around 18% of adults in the United States currently struggle with mental, behavioral, or emotional disorder.  Mental health and substance use disorders are now the leading cause of disease burden in the US.

Because the demand for mental health resources outstrips the supply, many organizations, such as hospitals, clinics, schools, and prisons, have turned to teleBehavioralHealth to help manage this vulnerable patient population.

What are the benefits of teleBehavioralHealth?

  • Emergency Departments: Remote psychiatrists can quickly consult with the patient and onsite staff for acute mental health emergencies. See also telePsychiatry.
  • Inpatient: Hospitals without onsite psychiatrists can request consultations from specialists to address sudden changes to patients’ mental health status in the hospital for other treatments.
  • Outpatient: Post-crisis mental health for those patients who are not an immediate threat to themselves or others; may have sought care in the emergency room and are now at home. In-person appointments can typically take weeks or months; these patients need help sooner in order to avoid a subsequent crisis.
  • Physician Offices and Clinics: Primary care providers are often the first healthcare professionals to become aware of patient mental health issues. Having access to teleBehavioralHealth care in the same familiar office via a private video conferencing room means patient convenience and more comprehensive care.
  • Schools: Using videoconferencing technology, mental health professionals can be available for students in crisis or for ongoing treatment
  • Prisons: Most prisons do not have a psychiatrist or other mental health professional on-site. Mental health professionals can safely see inmates over a camera and eliminate the need for either party to travel. See also: Sandra Bland Act
  • Substance Abuse Treatment Centers: Many substance abuse patients have underlying mental health issues; having a mental health professional available over video is part of a holistic treatment plan.

Conclusion

TeleBehavioralHealth is an efficient use of scarce mental health resources. With an increase in the number of patients with mental health and substance abuse issues, teleBehavioralHealth can help provide access to professionals quicker and more conveniently than in-person care.

Additional Resources

Using telePsychiatry to treat substance abuse

Using telePsychiatry to Treat Substance Abuse

From Failure to Future: The Ryan Leaf Story on Addiction Recovery

How telePsychiatry Decreases ED Overcrowding at CaroMont Regional

Sandra Bland Act Means Telemedicine is Coming to Texas Jails

Sandra Bland Act: Telemedicine is Coming to Texas Jails

7 questions to answer before implementing telePsychiatry

Better ROI for Emergency Psychiatric Services

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