Physician burnout and stress have reached alarming levels. Psychiatrists are at risk of experiencing burnout due to emotional stressors related to the nature of the clinical work, occupational hazards, changing nature of service delivery, and increasing administrative pressures. Currently, little is known about the impact of telepsychiatry on psychiatrist well-being and burnout. This Open Forum examines potential benefits and challenges of telepsychiatry with regard to psychiatrist stress and burnout. It also discusses the broader implications of telepsychiatry for psychiatrist wellbeing.

Despite the staggering physical, economic, and societal costs of mental health conditions in the United States, there continues to be a significant gap in mental health service, as access lags behind the demand for them. The uneven distribution of mental health service providers contributes to this gap, making it necessary to incorporate novel approaches to the delivery of mental health services. Telepsychiatry has proven to be one of the more innovative approaches for improving access to mental health services. This article focuses on six challenges that have historically impeded larger-scale adoption of telepsychiatry: limited training, limitations of existing research, security and technology issues, clinical practice challenges, licensure, and reimbursement restrictions. The article discusses recent developments, ongoing advances, and future directions to overcoming these barriers. [ Psychiatr Ann . 2019;49(2):82–88.]

ImportanceAdult sexual assault (SA) survivors experience numerous emergent health problems, yet few seek emergency medical care. Quantifying the number and types of survivors presenting to US emergency departments (EDs) after SA can inform health care delivery strategies to reduce survivor morbidity and mortality.ObjectiveTo quantify ED use and factors that influenced seeking ED care for adult SA from 2006 through 2019.Design, Setting, and ParticipantsThis cross-sectional study used SA data from the Nationwide Emergency Department Sample from 2006 through 2019, which includes more than 35.8 million observations of US ED visits from 989 hospitals, a 20% stratified sample of hospital-based EDs. The study also used the Federal Bureau of Investigation’s Uniform Crime Reporting Program, which includes annual crime data from more than 18 000 law enforcement agencies representing more than 300 million US inhabitants. The study sample included any adult aged 18 to 65 years with an ED visit in the Nationwide Emergency Department Sample coded as SA. The data were analyzed between January 2020 and June 2022.Main Outcomes and MeasuresAnnual SA-related ED visits, subsequent hospital admissions, and associated patient-related factors (age, sex, race and ethnicity, income quartile, and insurance) were analyzed using descriptive statistics.ResultsData were from 120 to 143 million weighted ED visits reported annually from 2006 through 2019. Sexual assault–related ED visits increased more than 1533.0% from 3607 in 2006 to 55 296 in 2019. Concurrently, admission rates for these visits declined from 12.6% to 4.3%. Female, younger, and lower-income individuals were more likely to present to the ED after SA. Older and Medicaid-insured patients were more likely to be admitted. Overall, the rate of ED visits for SA outpaced law enforcement reporting.Conclusions and RelevanceThis cross-sectional study found that US adult SA ED visits increased from 2006 through 2019 and highlighted the populations who access emergency care most frequently and who more likely need inpatient care. These data can inform policies and the programming needed to support this vulnerable population.

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