Telepsychiatry: Improving the Provider Distribution Model
Adoption of telepsychiatry is on the rise as healthcare stakeholders and communities increasingly recognize the benefits to behavioral health access. The convenience and flexibility of remote care models is not only addressing severe provider shortages, but also opening the door to more timely treatment, enhanced quality of care, and higher levels of satisfaction for both providers and individuals.
Provider shortages touch nearly every aspect of health care, but the situation is particularly dire for the behavioral health sector. Current estimates by the National Council Medical Director Institute suggest the demand for psychiatry will surpass supply by 15,600 psychiatrists—roughly 25 percent—by 2025. The reality is that 55 percent of U.S. counties—many geographically isolated—do not have a single psychiatrist. With the distribution of mental and behavioral health providers skewed both geographically and across clinical settings, the provider “mis-location” is a key challenge to accessing behavioral health care.
Simply put, increasing the number of psychiatrists alone will not solve the problem. There also is a critical need for telemedicine models that allow individuals to engage with mental and behavioral health providers remotely across geographies to increase access to such care and improve the behavioral health outlook nationwide.
Understanding Provider Mis-Location
Rural geographies naturally face greater mental and behavioral health resource challenges than do their urban and suburban counterparts. It’s not uncommon for the closest provider to be several hours away, particularly when a specialized provider is required. For example, nearly three-fourths of rural counties lack a psychiatrist, and more than 90 percent do not have a child and adolescent psychiatrist available.
In addition to geographical disparities, there is growing concern about the mis-location of mental and behavioral health providers across various clinical settings. Although public behavioral health settings and Medicaid-funded programs are most underserved, the industry is seeing growing provider shortages in outpatient clinics, hospital emergency departments (EDs), and care management programs. Notably, this trend touches urban and rural regions alike, creating service gaps and access challenges that often result in ED “boarding” within hospitals as well as months-long waiting lists for appointments in outpatient settings.
Addressing Psychiatry Distribution Gaps with Telepsychiatry
A key advantage of telepsychiatry is that it is unbound by location. Providers, including scarce subspecialties for children and geriatrics, can reach individuals across geographies and help fill growing service gaps. The Interstate Medical Licensure Compact is one example showcasing how the industry is advancing these models to allow providers to deliver services across state lines.
The reach of telepsychiatry extends across the continuum from the most acute settings to outpatient facilities to inside individuals’ own homes. Convenient, easy-to-use videoconferencing models are also increasingly seen in nontraditional settings such as skilled nursing facilities, correctional institutions, schools, and other settings within the community.
Telepsychiatry can improve patient access in the ED and across acute care settings by ensuring consumers receive timely evaluations and are triaged to the most appropriate care. Across communities, direct-to-consumer telepsychiatry offerings are becoming a critical referral option for discharge planners, primary care providers, employee assistance programs, and other social service agencies when local resources are scarce. With this care approach, individuals simply access services from the comfort of home or another private location at a time that fits within the parameters of work and family schedules.
Although the current supply and distribution of mental and behavioral health providers are areas of concern in today’s healthcare environment, telepsychiatry models affording better access to high-quality psychiatric care are continuing to be embraced across the country. Telepsychiatry offers a prime opportunity to address both the growing provider shortage and uneven geographical distribution, opening the door to more convenient and accessible care options, a more unified and connected system, and ultimately improved care outcomes.
Geoffrey Boyce is CEO, InSight Telepsychiatry, Marlton, N.J.