Objective. One approach to solving mental health care disparity issues in rural areas is by establishing a telepsychiatry consultation practice for children, in which a psychiatrist sees a child via videoconferencing for a limited number of sessions and then provides a treatment plan to that child’s primary care physician and family. Method. The present study offered a 2-session telepsychiatry consultation clinic, consisting of a psychiatric evaluation session and a recommendation session, with patients located remotely in rural Georgia. Results. Fifteen consultations with children aged 4 to 18 years (M = 9.73, SD = 3.39) with varying diagnoses were completed. Parental satisfaction with the telepsychiatry consultation model was high, overall mean of 4.58 (SD = 0.63) on a 5-point scale (n = 11). Conclusion. Establishing a child telepsychiatry consultation practice is feasible in rural areas. This report describes the benefits and challenges of our telepsychiatry consultation clinic with rural pediatric patients.
US House Committees on Ways and Means, Energy and Commerce, and Education and Labor. Affordable Healthcare for America: Health Insurance Reform at a Glance: Rural America. http://docs.house.gov/energycommerce/RURAL.pdf. Published March20, 2010. Accessed December 1, 2011.
2.
ShafferDFisherPDulcanMK. The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. J Am Acad Child Adolesc Psychiatry. 1996;35: 865-877.
3.
RingelJSSturmR. National estimates of mental health utilization and expenditures for children in 1998. J Behav Health Serv Res. 2001;28:319-334.
4.
CarrVJFaerhmannCLewinTJWaltonJMReidAA. Determining the effect that consultation-liaison psychiatry in primary care has on family physicians’ psychiatric knowledge and practice. Psychosomatics. 1997;38:217-229.
5.
TorstensonOL. The treatment of mood disorders in children and adolescents by general pediatricians. Biol Psychiatry. 2001;49:970-972.
6.
WilliamsJKlinepeterKPalmesGPulleyAFoyJM. Diagnosis and treatment of behavioral health disorders in pediatric practice. Pediatrics. 2004;114:601-606.
7.
OlsonALKelleherKJKemperKJZuckermanBSHammondCSDietrichAJ. Primary care pediatricians’ roles and perceived responsibilities in the identification and management of maternal depression. Pediatrics. 2002;110:1169-1176.
8.
The President’s New Freedom Commission on Mental Health. Subcommittee on Rural Issues: Background Paper. DHHS publication SMA-04-3890. Rockville, MD: US Department of Health and Human Services; 2004.
9.
BirdDCLambertDHartleyDBeesonPGCoburnAF. Rural models for integrating primary care and mental health services. Adm Policy Ment Health. 1998;25:287-308.
10.
LambertDBirdDHartleyDGenovaN. Integrating Primary Care and Mental Health Services: Current Practices in Rural Areas. Kansas City, MO: National Rural Health Association; 1996.
11.
LambertDDonahueAMitchellMStraussR. Rural Mental Health Outreach: Promising Practices in Rural Areas. Rockville, MD: US Department of Health and Human Services; 2001.
12.
StarrSCampbellLRHerrickCA. Factors affecting the use of the mental health system by rural children. Issues Ment Health Nurs. 2002;23:291-304.
13.
MyersKCainS; the AACAP Work Group on Quality Issues. Practice parameter for telepsychiatry with children and adolescents. J Am Acad Child Adolesc Psychiatry. 2008;47:1468-1483.
14.
HiltyDMYellowleesPMNessbittTS. Evolution of telepsychiatry to rural sites: changes over time in types of referral and in primary care providers’ knowledge, skills and satisfaction. Gen Hosp Psychiatry. 2006;28:367-373.
15.
MyersKMValentineJMMelzerSM. Feasibility, acceptability, and sustainability of telepsychiatry for children and adolescents. Psychiatr Serv. 2007;58:1493-1496.
16.
PakyurekMYellowleesPHiltyD. The child and adolescent telepsychiatry consultation: can it be a more effective clinical process for certain patients than conventional practice?Telemed J E Health. 2010;16:289-292.
17.
BoydellKMVolpeTKertesAGreenbergN. A review of the outcomes of the recommendations made during paediatric telepsychiatry consultations. J Telemed Telecare. 2007;13:277-281.
18.
YellowleesPMHiltyDMMarksSLNeufeldJBourgeoisJA. A retrospective analysis of a child and adolescent e-mental health program. J Am Acad Child Adolesc Psychiatry. 2008;47:103-107.
19.
RuskinPESilver-AylaianMKlingMA. Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment. Am J Psychiatry. 2004;161:1471-1476.
20.
ElfordRWhiteHBoweringR. A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. J Telemed Telecare. 2000;6:73-82.
21.
MairFWhittenP. Systematic review of studies of patient satisfaction with telemedicine. BMJ. 2000;320:1517-1520.
22.
HiltyDMNesbittTSKeunnethCACruzGMHalesRE. Rural versus suburban primary care needs, utilization, and satisfaction with telepsychiatric consultation. J Rural Health. 2007;23:163-165.
23.
MyersKMValentineJMMelzerSM. Child and adolescent telepsychiatry: utilization and satisfaction. Telemed J E Health. 2008;14:131-137.
24.
StarlingJRosinaRNunnKDossetorD. Child and adolescent telepsychiatry in New South Wales: moving beyond clinical consultation. Aust N Z J Psychiatry. 2003;11:S117-S121.
25.
AchenbachTM. Manual for the Child Behavior Checklist/6-18 and 2001 Profile. Burlington, VT: University of Vermont; 2001.
