Telepsychiatry: Advancing Connected Community Models

By Dr. James Varrell

The concept of “connected community” holds great potential for elevating and improving behavioral health outcomes for all patients. Connected communities proactively address a patient’s whole health—both physical and mental—and benefit from a comprehensive, multi-faceted behavioral health strategy.

Health care leaders recognize the potential of these models to positively impact clinical outcomes and reduce the need for higher-cost interventions by improving access to care at various points along the continuum. Yet, today’s communities often struggle to achieve this framework amid a severe shortage of psychiatric providers.

The reality is 96 percent of U.S. counties have unmet needs for mental and behavioral health services at a time when demand is soaring.¹ Current shortages leave those needing care with less-than-optimal choices. People often turn to primary care doctors, or alternatively, opt for no treatment at all—leading to further deterioration or crisis situations that result in costly interventions.

The good news is that direct-to-consumer (D2C) telepsychiatry can help fill these gaps and improve the outlook on connected community models. While D2C is a relatively new concept, other settings across the care continuum have leveraged telepsychiatry for the past two decades, including hospitals, inpatient units, community-based case centers and correctional facilities.

Leveraged through easy-to-use videoconferencing technology, D2C offerings are opening new doors to psychiatric providers for evaluation, consultation and treatment.

D2C Telepsychiatry: Expanding Access And Referral Options

Growth of D2C telepsychiatry in recent years has expanded as patients become more empowered and seek out convenient ways of managing their care. Patients increasingly prefer “anywhere, anytime” options like the D2C model because it enables access to care from the comfort of home—or other private locations—on their own schedule.

This type of care allows providers to be more proactive and address issues before conditions reach what Mental Health America (MHA) refers to as a “stage four” level of severity. In effect, better patient engagement can trigger greater follow-through with care plans and minimize the potential for symptoms and issues to escalate.

Telepsychiatry often gives providers greater insights into their patients’ environments. For instance, a colleague of mine is a therapist in New Jersey, and she’s been treating one of her patients for years in person. When my colleague started using D2C Telepsychiatry, she was able to see her patient online through real-time video calls rather than in person, and noticed right away that her patient was hoarding her belongings. My colleague was able to learn about her patient’s living condition and other factors that influenced her treatment plans. Further, her patient reported feeling more comfortable and at-ease during their appointments.

D2C telepsychiatry also provides more referral options, enabling earlier interventions and greater access to services. While frequently sought out as a mental health alternative, many primary care providers are uncomfortable prescribing psychotropic medications or lack psychiatry expertise.

By providing a reliable behavioral health referral option, D2C telepsychiatry takes the pressure off of primary care providers. Moreover, collaboration and information exchange between the referring physician and D2C provider can allow for more comprehensive care.

Outside of primary care, D2C expands referral options for discharge planning from acute and inpatient settings. The current mental health provider shortage can slow down referral processes, leading to disjointed transitions where patients must “settle” on whatever is available in the nearby area instead of what is best.

Closing The Loop To A Connected Community

Even as health care leaders increasingly embrace telepsychiatry models, most are currently used in siloes across community settings. However, there’s opportunity to leverage existing resources and establish community-wide telepsychiatry networks to connect all appropriate care settings.

This connected community model improves both information sharing between providers and continuity of care for patients. Patients can use telepsychiatry to see the same provider or same network of providers across different care settings or from home with D2C care. In tandem, primary care doctors, community organizations and telepsychiatry providers can better collaborate on patient care.

Telepsychiatry networks not only improve care outcomes, but also create economies of scale. For instance, health care settings can benefit from sharing a telepsychiatry provider network. This option places less pressure on community resources to recruit and retain local behavioral health providers.

Communities can take steps to utilize a telepsychiatry network across care continuums by:

• Bringing together payers, primary care, hospital systems, outpatient behavioral health, corrections, schools, skilled nursing and other community organizations
• Assessing their current behavioral health resources to identify gaps and opportunities
• Setting multiple locations up with technology to access telepsychiatry
• Establishing a telebehavioral health network of licensed providers who are aware of community services and resources
• Utilizing shared scheduling tools for booking psychiatric resources and appointments

Telepsychiatry helps address the gaps in behavioral health care across the continuum by proactively treating patients’ whole health through the concept of the connected community. By increasing patient access to care and referral options, this evolving model supports timely, proactive intervention, minimizing the potential need for more costly care and enabling better outcomes.

About The Author

James R. Varrell, M.D. is a child and adolescent psychiatrist who has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry. InSight's direct-to-consumer division that accepts patient referrals for psychiatry and therapy is called Inpathy.