International telepsychiatry: a study of patient acceptability

Abstract

An international telepsychiatry service was established between Denmark and Sweden for cross-cultural patient groups, such as asylum seekers, refugees and migrants. Over an 18-month period starting in mid 2006, 30 patients were treated by telepsychiatry (21 men and 9 women). The patients received mental health care by videoconferencing from providers who spoke the patients' own language, i.e. without the assistance of interpreters. The total number of telepsychiatry sessions was 203 (range 1-22; average 6.8 sessions per patient). Patients completed a satisfaction questionnaire at the end of treatment. Seven patients (23%) were not able to complete a questionnaire, due to illiteracy and/or a psychotic condition. The rest of the patients (n=23) reported a high level of acceptance and satisfaction with telepsychiatry, as well as a willingness to use it again or recommend it to others. Any disadvantages of telemedicine were compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. Mentally ill asylum seekers, refugees and migrants are under-served in their mother tongue and telepsychiatry can improve access to scarce health-care resources.

Barriers to Use of Telepsychiatry: Clinicians as Gatekeepers

“…70,71 Another unique advantage of telepsychiatry in terms of rapport building is the possibility for patients (especially immigrants, refugees, and asylum seekers) to receive care in their native language without the assistance of an interpreter. 69,72 Exposure to these advantages may help mitigate clinician's concerns, as successful therapeutic relationships have been established using telepsychiatry across multiple patient populations and psychiatric symptoms. 68,71,[73][74][75][76] COMMUNITY/CULTURAL Telepsychiatry practice often involves challenging culture gaps 16,77 and differences in values.…”

Piloting Forensic Tele-Mental Health Evaluations of Asylum Seekers

“…International literature suggests that refugees and asylum seekers report high levels of satisfaction with tele-psychiatry, but further research is needed to confirm these findings in the specific population our program serves. 7,8 The scope of the remote network is limited because MSHRP is currently only able to work with clients who have direct legal representation. By some estimates, just 14% of people in U.S. immigration detention have representation, and rates of representation for individuals who are barred from entering the U.S. under the MPP range from 0-11%.…”

Telepsychiatry as an Economically Better Model for Reaching the Unreached: A Retrospective Report from South India

“…[56] In all, telepsychiatry was found to be cost-effective and comparable in clinical outcomes compared to the usual care. [78]…”