A rapidly growing specialty can help close the gap between doctors and patients.
Though her patients often sit miles away, Naomi Ambalu has seen firsthand the impact of telepsychiatry. "I feel that every family we've been able to see via telepsychiatry we've positively impacted," says Ambalu, D.O., a child and adolescent psychiatrist at Children's Specialized Hospital in Mountainside, New Jersey. "If we were not able to provide that service for them, they would be waiting months longer for any mental health services."
Lack of access to mental health care "has created a crisis throughout the U.S. health care system," according to a 2017 report from the National Council for Behavioral Health. It cites data showing 77 percent of counties nationwide as being underserved, with more than half of states having a "serious shortage" of child and adolescent psychiatry services.
And the crisis is expanding; the report predicts demand for psychiatry services will outstrip supply by as many as 15,600 psychiatrists—or 25 percent—by 2025. Telepsychiatry is a rapidly growing specialty that could help address the nation's mental health care shortage.
Benefits of telepsychiatry
Using videoconferencing technology, telepsychiatry enables mental health practitioners to interact with patients in virtually the same manner as they would in a face-to-face meeting. For patients, that means easier access to the limited number of psychiatric professionals, a much shorter wait time to see the doctor and no need to travel a great distance for an appointment.
For doctors, Ambalu says the benefits are very similar. They're able to see more patients in a day than they would if they had to travel to multiple clinics. And more frequent appointments help them provide better follow-up care for their patients.
At Children's Specialized Hospital, Ambalu has treated more than 150 families via telepsychiatry since the program's inception two years ago. Although her patients attend appointments at one of the hospital's four clinics across New Jersey set up for telepsychiatry, she says the technology is applicable in a number of settings, including inpatient facilities, juvenile correctional centers, schools, primary care settings and even a patient's home. Reaching patients remotely is a primary benefit of the practice, but Ambalu says sometimes it actually can have advantages over a conventional in-person visit.
"Telepsychiatry provides an added benefit for the adolescent and childhood populations," Ambalu says. "They may have an extreme fear of doctors, but with telepsychiatry the fear is not as strong because they have separation. And the younger population is very comfortable with technology, so there's the psychological aspect of feeling they are in a safer place."
Addressing coverage needs
Still, challenges to further adoption remain—primary among them is inconsistent coverage by commercial insurance providers, according to Ambalu. She says ongoing advocacy efforts are key to making telepsychiatry available to children who can benefit from the service. "Advocacy efforts must be focused," Ambalu says. "But I believe that telepsychiatry will continue to grow as administrators and consumers further understand the many benefits of telepsychiatry and the positive impact it can have on communities nationwide."
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