Roosevelt Institute | Cornell University

Face time or FaceTime®?

By Angelica CulloPublished November 9, 2014

Despite pleas from the family doctor, your brother refuses to seek help for his worsening major depression. He doesn't want to leave the house, he doesn't want to be seen going to the psychiatrist's office, and plus, his family doesn't have health insurance. What about speaking with the psychiatrist via teleconferencing? Advances in secure telecommunication technologies in conjunction with increased need for mental health services has prompted a recent push to improve access and viability of "Telepsychiatry" that could improve access for such patients.

By Angelica Cullo, 11/9/2014

According to the National Institute of Mental Health, 26% of Americans 18 and older have a diagnosable mental disorder. While these disorders are the leading cause of disability in the USA and Canada, more than 50% of those patients don't get the treatment they need.

In the last decade, the demand for psychiatric and mental health services has grown drastically. From 2007 to 2010, Merritt Hawkins reported a 121% increase in patient requests for psychiatrists, and emergency rooms have seen more visits related to mental health and substance abuse, with an increase of 17.7% between 2008 and 2010.

Telepsychiatry, or the use of video communication systems to provide psychiatric services, has the potential to address many challenges that face delivery of mental health services. Such services would (and have already begun) to reduce medical costs for both the providers and the patient. Not only are there direct savings - no travel costs and fewer expenses to manage or run an office building, but telepsychiatry also has indirect benefits. Over $300 billion per year is spent on indirect costs of serious mental illnesses, including the cost of inpatient stays, disability benefits, and loss of earnings, and telepsychiatry has the potential to lower that spending.

In addition to economic  benefits, telepsychiatry has been reported to improve health outcomes. Digital communication options make seeking treatment more convenient, allow individuals with disabilities or lack of transportation to more easily access care, and reduce the stigma associated with visiting the psychiatrist's office. 

Studies have already begun to report improved outcomes resulting from the use of telepsychiatry.

According to research by the University of Arizona, patients who used telepsychiatry (vs. the control group that received in-person treatment) demonstrated a greater adherence to antidepressant medication, reported higher satisfaction with care, completed the same number of visits as the in-person group, and twice as many said they would pay for further treatment.

Of course, there are considerations to make before telepsychiatry can become a viable option. Telepsychiatry brings up the issue of physician state licensure. Because there currently is no national licensing system, psychiatrists and other mental health providers ( i.e. social workers) can only treat patients in the states where they hold licences. But for now, this is a small hurdle, one that still allows telepsychiatry the opportunity to become a viable healthcare option.

With digitalization becoming the norm, is this just an extension of that trend? What's your preference, face time or FaceTime?