Telepsychiatry – Access to Care when Patients Need It

By Matthew B. Stanley, DO
Vice President of the Behavioral Health Service Line, Avera Health
ABT Founding Board member

As a psychiatrist serving patients in rural South Dakota, telemedicine changed how I practice medicine.

In the last year, we navigated a global pandemic where people stayed home to stay healthy. Acceptance of telemedicine advanced in just a few months instead of a decade. Clinicians, hospitals and health systems recognized quickly that telehealth allowed for continuity of care and for some, new ways to interact with their patients.

In one of our specialty eClinics, for example, I now see some of my elderly and impoverished patients with telehealth appointments, a change I did not expect. However, my colleagues and I truly underestimated the prevalence of smart phones in this population.

These patients missed appointments because they couldn’t afford gas, get off work or find childcare. Now, with telehealth, they have easier access to care with their smart phones. Previous barriers disappeared because people now receive care in their own homes. And many of them don’t want to return to the way it was before.

The pandemic also revealed where we are as a society, that is, the prevalence of health disparities that begins with access to quality care. I’ve seen a higher incidence of people with suicidal thoughts, anxiety and mental health challenges in rural communities. As pressures continue to rise, alcohol and substance abuse may also increase and potentially result in violent behaviors.

For patients in any part of the country, but especially in rural communities, telemedicine gives clinicians access to people when they need us. We are more available to patients at the time of the crisis, often with a telehealth appointment via a phone call or video connection.

Psychiatry still carries a stigma for many, a barrier that often prevents them from seeking care in-person. In a small community with one clinic, people drive by the parking lot and sometimes recognize the car of friends or family. Rather than answer questions about why they were at the clinic, patients now can talk with their psychiatrist or other behavioral health professional in the privacy of their own homes.

As I look ahead, telemedicine will provide access to care for many patients as we face a shortage of psychiatrists and other mental health professionals. With remote care, we can make the best use of the resources we have. A new wing, funded in part by the Helmsley Charitable Trust, will soon be part of the Avera Behavioral Health Center in Sioux Falls, S.D. This addition will provide much needed in-person and telehealth services for patients, including youth and adolescents, within a 250-mile radius.

We discus telehealth as an extension of our current medical system but it is a unique form of healthcare delivery with components that demand understanding and knowledge. With that premise in mind, ABT took a necessary step to assure that providers and administrators offer high-quality telehealth services and to seek to standardize the delivery of telehealth. No review body is currently monitoring development of this increasingly critical avenue to health care.

As a member of ABT’s Founding Board, I know the CORE Concepts in Telehealth Program course provides education that will help instill confidence for anyone who might be anxious about practicing telemedicine. At the same time, we want to ensure that we never lose track of the patient with care of the same quality delivered in an urban community as well as rural South Dakota. In addition, we are excited to now offer our TeleBehavioral Health Certificate Program that will deliver next level training, specifically for mental health practitioners.

Learn more about ABT’s CORE Concepts in Telehealth Certificate Program.