A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

Abstract

The access of rural Mental Health Care Users in South Africa to specialist psychiatrists and quality mental health care is currently sub-optimal. Health professionals and planners working in psychiatry lack a well-defined and feasible outreach model to facilitate the delivery of services to remote and rural areas. In response to this challenge, a three-year action research telepsychiatry study was undertaken by the Departments of Psychiatry and TeleHealth at the University of KwaZulu-Natal, to develop a telepsychiatry outreach model based on local research and international evidence. The Model draws on needs and infrastructure assessments of the designated psychiatric hospitals in the province, a review of the published international evidence on telepsychiatry and videoconference-based education, and an evaluation of local clinical and educational telepsychiatry implementations in KwaZuluNatal. The Model proposed is "virtual", i.e. not bound to provincial or district referral patterns, aims not to add to the burden on the current workforce and is intended to be integrated into psychiatry outreach services and policy. The Model should be subjected to in situ testing for validation and implementation. It is hoped that an implementation of this Model will improve the access of Mental Health Care Users to specialist psychiatry care.

Review of calls to an Australian teratogen information service regarding psychotropic medications over a 12‐year period

“…Rural residency in fact predicts decreased utilisation of psychiatric services, although living in rural areas does not decrease the risk of psychiatric conditions for perinatal patients. The deficiencies of services for such patients is an international problem and telepsychiatry is increasingly utilised even in poorly resourced nations, as a supplementary tool for improving mental health care . Calls regarding lithium did not change significantly between the 2 epochs, and this is also consistent with the data from Stephenson et al …”

Telepsychiatry in India - Where Do We Stand? A Comparative Review between Global and Indian Telepsychiatry Programs

“…Out of the 360 articles obtained after database search, we finally identified 32 relevant articles[910111213141516171819202122232425262728293031323334353637383940] and those were included in our review. The details of the study types, designs, and outcomes are described in Table 1.…”

Enabling factors for specialist outreach in western KwaZulu-Natal

“…18 The use of telehealth, videoconferencing for tele-education or telemedicine (the clinical application of telehealth) is well described in the rapidly burgeoning international literature as being of value in MSO. 29 , 30 , 31 , 32 Although telehealth should enable MSO but not replace it, there was stern criticism of the inadequacies of the technology employed. This is corroborated by the experience of an author (R.I.C.)…”