The growth of telemedicine for mental health

What are the benefits of telemedicine in mental health?

• Convenience – The convenience of telemedicine may be especially beneficial for individuals who find in-person appointments difficult due to work, caregiving responsibilities, physical or psychological challenges.

• Improved access – Telemedicine improves access to mental healthcare professionals, as geographical distance is eliminated. It may also help extend capacity where there is a shortage of mental health professionals. 

• Continuity of care – Patients are less likely to miss appointments and can also access help and advice more quickly if they are experiencing difficulties. This has great potential to improve outcomes for mental healthcare treatment.

• Efficiency savings – Remote mental healthcare delivery can reduce overheads and enable more efficient use of clinical resources. Patients save time and travel costs by seeing their therapist virtually.

• Home-based care – Many patients feel more at ease in their home environment. They may worry about being  seen going to a psychiatric office due to fear of being stigmatized. Teleconsultations may also provide doctors with insights into living conditions which may impact patients’  health. 

• Empowering self-care –  Mobile apps and other media can be used to motivate and empower patients to monitor and look after their own mental health.

What challenges are associated with the use of telemedicine?

• • Privacy concerns – Confidentiality and privacy of conversations and sensitive patient data must be ensured.
  • Offscreen distractions – There may be noise and distractions during videoconsulations.

• • Reduced nonverbal cues – It may be more difficult for clinicians to pick up on non-verbal cues during virtual visits.
  • Technical issues and usability – Both clinicians and patients should be comfortable using the technology. The appropriate infrastructure and connectivity should be in place.
  • Licensing and insurance issues – Providers must stay up to date with local regulations on the use of telemedicine. 
  • Safety issues – Clinical judgement must be used  to decide whether telemedicine is appropriate in each case. Protocols for obtaining informed consent and handling emergencies must be in place. 

The use of remote digital care provision is complementary to, but does not replace in-person care.

What is the evidence for telemedicine in mental health care?

There is substantial evidence supporting the use of telemedicine interventions in patients with mental disorders. Research has found that telemedicine has the ability to increase access and quality of care, compared to in-person treatment. 

A review of studies on remote psychiatric counseling found high levels of consistency between remote and in-person psychiatric assessment. 

A review of outcomes in telepsychiatry found that,  overall, mental health interventions delivered via telepsychiatry resulted in similar treatment outcomes to those delivered face to face. The review also found that telepsychiatry reduced direct and indirect costs and increased quality of life adjusted years. 

Studies using questionnaires, interviews, and mixed-methods assessments suggest that the majority of patients are comfortable using telemedicine and appreciate the practical benefit of avoiding travel.

A systematic review  of  app and SMS based health interventions provides promising indications of their efficacy to improve a patient’s physical and mental health state and  increase medication adherence. Apps were shown to be effective when used as an intervention for stress, anxiety, and depression.