Patients with PTSD, Bipolar Disorder Engaged With Telemental Care

As providers take steps to figure out the applicability of telepsychiatry and telepsychology, a study published in the Journal of General Internal Medicine found that patients experience benefits from two specific approaches: telepsychiatry collaborative care (TCC) and telepsychiatry enhanced referral (TER).

The study included 1,004 participants who had been diagnosed with either posttraumatic stress disorder or bipolar disorder, and they were each assigned to either TCC or TER as a method of care.

TCC consists of a team-style method, involving a primary care provider, care manager support, and treatment recommendations from a telepsychiatrist. Meanwhile, TER involves direct communication between the patient and a mental health clinician.

The TCC arm included 506 participants, and the TER arm included 498.

Study participants had to be 18 years of age, not taking psychotropic medication, and have the ability to speak English.

Researchers gathered data on the participants from 24 primary care clinics associated with 12 federally qualified health centers in three different US states. The FQHCs that participated in this study did not have a psychiatrist or psychologist on site.

Though both the TCC and TER approaches have the potential to work, the data showed that the level of engagement in TCC visits exceeded that of TER.

TCC patients averaged 9.6 encounters, and TER patients averaged 6.4 meetings. The reason for the higher level of engagement within TCC was likely linked to its more proactive and efficient approach when connecting patients with mental health services.

"The study started at a time where clinicians had reservations about treating psychiatrically complex patients with telehealth or integrated care models. Understandably, engagement in care was one of the many concerns," said Jennifer Severe, MD, co-leader of the study and clinical assistant professor at Michigan Medicine, in the news release. "This study showed that patients with multiple psychiatric conditions and who also struggle with several chronic physical health problems can engage well in mental health treatment with their primary care doctors or remote mental health specialists."

The belief that telehealth will continue to be beneficial for both patients with mental health conditions, as well as at FQHCs, has been widely expressed in recent years, especially as the COVID-19 pandemic continues.

For instance, a five-year study published last year showed that FQHC providing telepsychology/telepsychiatry resources can help extend access to care, including for those who reside in rural areas.