Adolescents Respond Positively to Behavioral Healthcare Delivered through Televideo Equipment

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Three months ago, the Developmental Adolescent Residential Treatment Program (DART) at Hope Network began beaming in a remote psychiatrist to do intake evaluations and follow up medication management for their young residents. Both staff and consumers are pleased with the level of care provided via telepsychiatry from InSight Telepsychiatry; Young people find safety and amusement in seeing psychiatrists on a television screen rather than in person, while staff enjoys the efficient and consistent physician telepresence.

The kids really enjoy seeing Dr. Brancato on the television screen. They seem more interested and find Dr. Brancato’s telepresence novel and fun,

Its Monday afternoon, and the care team at DART, a residential treatment program for adolescents with neurodevelopmental conditions, is gathered. Providing appropriate care to DART’s young residents is a collaborative effort. The program director, a psychologist, a behavior analyst, a case manager, a nurse and a psychiatrist all offer professional perspective. With every team member having a slightly different area of expertise the team meetings are designed to provide comprehensive treatment. The meetings work just like you would imagine, with one small tweak: the psychiatrist, Dr. Peter Brancato is 730 miles away in his New Jersey office.

Dr. Brancato is a telepsychiatrist -- he connects to patients in Michigan and other states throughout the country through a secure, HIPPA compliant video connection.

“The kids really enjoy seeing Dr. Brancato on the television screen. They seem more interested and find Dr. Brancato’s telepresence novel and fun,” said Nicole Grajewski, DART program director, “Kids love technology in general so applying it to their behavioral healthcare makes sense.”

Grajewski sites examples of patients dancing in front of the camera and opening up to Dr. Brancato in new and different ways.

“I think some of the kids feel safer talking to Dr. Brancato rather than their in person clinicians because he is on a screen,” Grajewski said.

This supports research findings stating that adolescents respond well to telepsychiatry because of their comfort with the technology and because there are fewer power dynamics at play in a psychiatric session conducted via telemedicine. Ref: 1

“I’m not sure why the kids open up to me, but many of them do,” Dr. Brancato explains. “Our televideo interactions are just a small part of their treatment though; it is very much a team approach. The onsite clinicians at DART interact with the kids every day- its hard work.”

Dr. Brancato’s primary role in the treatment team is to provide pharmacological expertise to augment the intensive face-to-face therapy and care the adolescents at DART receive.

In addition to the positive adolescent response, the DART staff is also complimentary of using telemedicine to fulfill their facility’s psychiatric needs.

According to Grajewski, psychiatric evaluations done via telemedicine often go more quickly than in person evaluations. She attributes this efficiency partially to the children being more willing to quickly open up to Dr. Brancato on the screen.

Though telepsychiatry requires a bit of administrative work in terms of sending information back and forth to Dr. Brancato, overall the staff at DART is satisfied with the telepsychiatry services.

“Telepsychiatry has been more reliable for us than in person physicians. We know Dr. Brancato is going to be there when he is scheduled,” Grajewski said.

Dr. Brancato’s services are provided by InSight Telepsychiatry, LLC, a national telepsychiatry provider company that has been practicing telepsychiatry since 1999.

Telepsychiatry has become increasing popular in recent years because of the difficulty many facilities have in recruiting and maintaining quality psychiatric professionals, especially child and adolescent psychiatrists.

“There is a national shortage of psychiatrists. Many facilities previously had to choose between paying exorbitant salaries to temporary physicians or going without psychiatric care all together. Thus, telepsychiatry is an excellent way to address part of that problem for underserved communities,” said Dr. Jim Varrell, Medical Director of InSight.

“The hardware necessary for a seamless connection between a consumer and provider is more accessible and affordable than ever before,” said Dr. Varrell.

Though most states are still working to change reimbursement structures for telemedicine, Dr. Varrell is hopeful for a future where technology can be leveraged to address behavioral health everywhere.

“Behavioral healthcare is conducive to telemedicine because the “exam” is essentially just a conversation. We find that psychiatric care via televideo conferencing is extremely effective, especially when providers work collaboratively with in person clinicians like Dr. Brancato does at Hope network, “ Dr. Varrell said.

Reference 1: Myers K, Valentine J, Melzer S. Feasibility, Acceptability, Sustainability of Telepsychiatry for Children and Adolescents. Psychiatry Services 2007; 58(11):1493-6.

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