Varun Choudhary & John Urbach: Technology eliminates barrier to care

IN A MENTAL health crisis, the sooner the intervention by a mental health professional, the better the outcome for the patient. With the advent of telepsychiatry — psychiatric care delivered to patients via digital means such as videoconferencing — connecting with care can be as simple as opening an app on a phone.

The prospect of supplementing in-office visitations with telepsychiatry will vastly improve comprehensive care, especially for rural Virginians. Transportation, which costs patients both time and money, is one of the biggest barriers to accessing mental health services. The perceived stigma of issues mental health can also hinder care yet is decreased when patients talk to a psychiatrist from the privacy of their homes.

Transportation, which costs patients both time and money, is one of the biggest barriers to accessing mental health services.

Telepsychiatry has been demonstrated to markedly improve mental health care and the Psychiatric Society of Virginia is dedicated to ensuring that the approximately 25% of Americans who suffer from a mental illness have access to these life-changing services.

But for the estimated 660,000 Virginians who do not have access to broadband, or high-speed internet, telepsychiatry is not an option.

Rural mental health patients are already at a disadvantage, since most do not have a local provider and must travel a great deal to receive care. For instance, the County Health Rankings by the Robert Wood Johnson Foundation found that several Tidewater localities, such as York County, the city of Chesapeake, and communities on the Eastern Shore all have a ratio of citizens to mental health providers of more than 1,000:1, almost double the average rate of other Virginia localities, and triple the national average. For the Isle of Wight County, that same ratio is 4,060:1, six times the state average.

Geographic challenges, sometimes coupled with other obstacles, such as the patient having a disability, or lacking reliable transportation or adequate insurance, may prohibit care entirely. Telepsychiatry could be the lifeline to these forgotten communities, but they need broadband to access the services in the first place.

One example of the critical value of such technology can be seen in the correctional arena.

One of us — Dr. Varun Choudhary, a past president of the Psychiatric Society of Virginia — was the sole psychiatrist for more than 1,100 prisoners in the Southwest Virginia Regional Jail Authority and the Blue Ridge Regional Jail Authority from 2006-11. This was an underserved and high-needs population, which had no access to mental health services prior to the introduction of telepsychiatry.

If a patient can connect to the internet, they can connect to care.

The same equipment used for video court arraignments in all the facilities was utilized to bring mental health services to these inmates. Prior to the introduction of this service, there were high rates of suicide attempts, self-harm behaviors, substance abuse, psychosis leading to isolation, and untreated mood and anxiety disorders. The use of telepsychiatry allowed these inmates to receive the mental health treatment they needed without any sacrifice in quality of care delivered.

The Psychiatric Society of Virginia, representing more than 600 psychiatrists and psychiatry school residents in the state, understands the importance of broadband as it relates to mental health. We are proud to have joined 75 other organizations in support of universal broadband coverage for Virginia within the decade. With approximately 25% of Americans suffering from a mental illness, the impact for connecting rural Virginia health would be highly beneficial for thousands.

There is common consensus among state legislators for the need to improve how we deliver mental health services to our citizens. Increased investment in broadband needs to be a part of any policy considerations going forward.

Bridging the digital divide adds another avenue to meaningfully impacting the thousands of Virginians with mental illness who have been left behind. If a patient can connect to the internet, they can connect to care.

Varun Choudhary, MD is the Medical Director at Good Neighbor.

Varun Choudhary, M.D., is the Medical Director at Good Neighbor and past president of the Psychiatric Society of Virginia. John R. Urbach, M.D. is the current president of the Psychiatric Society of Virginia.

Reposted from The Virginian-Pilot with author permission.