TagScott

Reading of the Week: Telepsychiatry – the Reality, the Potential, the Problems

From the Editor

Just a handful of months ago, mental health work didn’t require a webcam or a lighting ring, and no one talked about Zoom fatigue. The world is different now, obviously. With COVID-19, telepsychiatry is very much part of our clinical work.

This week, we consider three papers focused on telepsychiatry and our new world.

How widespread is the adoption of telepsychiatry in this pandemic era? In the first selection, Jonathan Cantor (of the RAND Corporation) and his co-authors draw on a big American database to answer that question. In Psychiatric Services, they write: “During the COVID-19 pandemic, the percentage of outpatient mental health and substance use disorder treatment facilities offering telehealth has grown dramatically. However, our analyses also indicated that considerable proportions of mental health and substance use disorder treatment facilities still did not offer telehealth as of January 2021…”

theapy

In the second selection, John C. Fortney (of the University of Washington) and his co-authors consider two different types of care: with psychiatrists directly involved in patient care (through televideo) or indirectly, by providing support to primary care. In a JAMA Psychiatry study, they do a comparison. Spoiler alert: both approaches were effective, suggesting great potential, especially for those in rural areas.

Of course, not everyone is enthusiastic about telepsychiatry. In our third selection, Dr. J. Alexander Scott (of the University of Michigan), a resident of psychiatry, describes his ambivalence. His Academic Psychiatry paper starts memorably: “Admittedly, I’ve never liked telemedicine.” He outlines some of the problems with our digital world.

DG

Continue reading

Reading of the Week: Innovation & Pandemics (NEJM); Also, Telemental Health & Practice (QuickTakes) and Scott on Isolation (NYT)

 

From the Editor

After a short break, the Readings are back. And the world has changed over these past weeks.

We are all dealing with the stress of the pandemic, both at home and at work. I spoke recently with a physician who is a young mother, and she talked about balancing her different obligations, and working to keep her patients and family safe.

These are challenging times.

I want to acknowledge the frustration that we all have, particularly the PGY5s, who are so close to completing their studies but have had their Royal College examination postponed. It’s a tough moment for our young colleagues. But I have a few grey hairs, and have seen tough moments come and go – and I believe that things will work out just fine.

This week’s Reading includes three selections.

In the first selection, we consider innovation in the age of pandemic, with a new NEJM paper by Drs. Judd E. Hollander (of Thomas Jefferson University) and Brendan G. Carr (of Sinai). They discuss telemedicine and COVID. “Disasters and pandemics pose unique challenges to health care delivery. Though telehealth will not solve them all, it’s well suited for scenarios in which infrastructure remains intact and clinicians are available to see patients.”

mobile_phone_with_stethoscope_showing_technology_and_health_stock_photo_slide01

Then, we take a practical turn. Many of us clinicians use telemental health; with COVID, many more are thinking about taking the virtual care plunge. In the second selection, we consider a new podcast discussing telemental health. I talk with Dr. Allison Crawford of the University of Toronto. And, yes, she has tips on how to up your virtual care game. And to those thinking about using telemental health, she offers simple advice: “Do it. Try it.”

Finally, in the third selection, we look at a NYT essay by an astronaut. Thinking about his time and isolation in space, Scott Kelly provides some clever advice. “I’ve found that most problems aren’t rocket science, but when they are rocket science, you should ask a rocket scientist.”

DG

Continue reading