Acceptability and cost-effectiveness of military telehealth mental health screening.

Abstract

Telehealth has been touted as one solution to the shortage of mental health providers within the military. Despite developing evidence for the equivalence of telehealth mental health care, there is no research that covers the use of telehealth for population mental health screening, a standard component of postdeployment medical screening. This paper summarizes soldier perceptions of three separate screening events in which telehealth was used and the cost-effectiveness of telehealth versus in-person implementations of the same screening. Soldiers who have not been through telehealth screening report a strong preference for in-person screening. Soldiers who have been through telehealth screening still report preference for in-person screening, but they express more ambivalence about the screening method. Using telehealth-only mental health screening for large numbers of soldiers within a compressed time frame is more expensive than in-person screening. Telehealth resulted in higher referral rates than in-person screening. Government and military leaders should use care when making decisions about telehealth implementation. Although telehealth for small numbers may be sufficiently equivalent and economical, there is no evidence of cost savings or improved acceptability for telehealth mental health post-deployment screening.

Telemedicine: A Cost-Reducing Means of Delivering Psychotherapy to Rural Combat Veterans with PTSD

“…A study investigating telehealth mental health screening with military populations post-deployment found that using telehealth to screen large numbers of Veterans was more expensive than in-person screening. 42 Given the current lack of studies addressing the cost-effectiveness of telemedicine and discrepancies in the findings in this area of research, future investigations of the cost of this delivery modality are warranted.…”

“…43 Furthermore, providing services via telemedicine requires additional training, administrative support, and technological expenses beyond those necessary for traditional clinical care. 42 In the future, payers, providers, and policy makers need to work together in order for telehealth to be adopted by a larger number of health service providers. 44 The current study represents a retrospective analysis of data from a randomized controlled trial that demonstrated non-inferiority of clinical effectiveness and comparable process outcomes for a groupadministered cognitive behavioral treatment for anger management delivered via CVT compared with in-person delivery.…”

“…Providers of mental health treatment via telemedicine must establish specific plans for dealing with patients who are at risk. 42 Another prominent concern is the lack of reliable, long-term reimbursement mechanisms, 37 which can be especially problematic if the provider is delivering the treatment remotely from a location outside of a hospital. 38 The cost-effectiveness of telemedicine may also be dependent on the providers' workload.…”

Consumer Information and Treatment Resources for Posttraumatic Stress Disorder

“…The majority of these studies compared the costs of different treatments and therapies for PTSD-afflicted individuals, especially compared to usual treatments of PTSD (psycho-and pharmacotherapy). [72][73][74][75][76] Regarding the small selection of studies in aggregate, it is apparent that the costs of different treatments vary widely.…”

Review of Mobile Health Technology for Military Mental Health

“…'7 DoD telemedicine programs have also been dedicated to mental health,58 although cost savings and effectiveness are still being evaluated. 59 The VA has also extensively imple mented telemedicine programs,60 including those for mental health.61,62 Implementation of telehealth has enabled the development of mHealth approaches in the Military Health Service (MHS).63,64 Second in importance to command sup port is the identification of local clinical champions who will support the adoption and sustainment of mHealth initiatives.…”