Telepsychiatry: effectiveness and feasibility

Abstract

Providing psychiatric services by real-time videoconferencing has been increasingly adopted as a method of reaching hard-to-serve populations since the early 1990s. As the field has expanded, a growing body of research has developed investigating both how telepsychiatry compares to in-person psychiatric care and how effectively telepsychiatry can be implemented in routine clinical care. A narrative review was performed to consider the evidence that telepsychia-try is feasible and effective across a variety of patient populations and clinical settings. There is a growing body of evidence investigating the efficacy of telepsychiatry when used for psychiatric assessment and treatment in the adult, child, and geriatric populations. Though studies vary in quality, they generally demonstrate that telepsychiatry is effective across multiple age groups and clinical settings. Telepsychiatry is generally well accepted by patients and clinicians and is feasible to implement, with the suggestion that some patients may actually prefer telepsychiatry to in-person treatment. Issues to consider in the implementation of telepsychiatry services include funding and reimbursement, medico-legal issues when provision crosses legislative boundaries, incorporation into existing health systems, and crosscultural considerations. Future directions for research and practice include a need for higher-quality efficacy studies, consideration of data security, increased attention to low-and middle-income countries, and the introduction of novel technological approaches.