Child and adolescent telepsychiatry: variations in utilization, referral patterns and practice trends

Author:

Myers Kathleen M12,Vander Stoep Ann13,McCarty Carolyn A45,Klein Jesse B6,Palmer Nancy B4,Geyer John R4,Melzer Sanford M5

Affiliation:

1. Department of Psychiatry and Behavioural Sciences, University of Washington School of Medicine, Seattle, Washington

2. Department of Child Psychiatry and Behavioural Medicine, Seattle Children's Hospital, Seattle, Washington

3. Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington

4. Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington

5. Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington

6. Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago, Illinois, USA

Abstract

Seattle Children's Hospital is a tertiary referral hospital that has provided telepsychiatry to seven partner sites in the north-west since 2001. Service utilization data, patient demographics and diagnoses were collected for the period from the service inception in October 2001 until November 2007. During the study period, 701 patients were treated with a mean of 2.8 appointments per patient (SD 1.9). Five psychiatrists and four psychologists provided care. Utilization varied across referring sites and was largely dependent upon the availability of telepsychiatrists, although the degree of support from administration and stakeholders also contributed to the success of the service. A total of 190 primary care practitioners referred patients to telepsychiatry, including 106 family physicians and 71 paediatricians. Paediatricians referred to the service more frequently than family physicians ( t = 2.8, P < 0.05). Overall, telepsychiatry with young people is feasible, acceptable and increases access to mental health care. There appear to be four core components necessary to a successful telepsychiatry programme: psychiatrists who are interested in exploring new ways to reach underserved young people; clearly identified stakeholders who can collaborate with one another to make good use of the telepsychiatry service; a children's mental health ‘champion’ who represents these stakeholders and wants services for their community; and a stable administration that perceives telepsychiatry as valuable for their patients and their doctors.

Publisher

SAGE Publications

Subject

Health Informatics

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