Report from the Alberta Heritage Foundation for Medical Research

Abstract

and five general hospitals was implemented in June 1996. The Provincial Mental Health Advisory Board worked in partnership with four Regional Health Authorities in the selection of sites, development of procedures, and evaluation. Information was collected through questionnaires administered to consumers, service providers, and psychiatric consultants. Additional information was obtained by interviews, site visits, logs, and telephone interviews with consumers. Sites were phased in over a 3-month period. In total there were 109 consultations, of which 19 were for repeat consumers. Referrals were received from 31 physicians. Seventy-five percent of consultations were to general psychiatry and the remainder to a psychogeriatrician or a psychiatrist specializing in substance abuse. Utilization was not equal across the sites in central Alberta and did not appear to be related to distance from other psychiatric services. Issues that may have affected the number of referrals were the level of involvement during the planning process of physicians and community mental health professionals, and type and timing of marketing, perceived need for the service by physicians, comfort and satisfaction with usual referral patterns, and skepticism regarding the new technology. The most common reason for referral was the management of a previously established diagnosis. Fifty-five percent of all consumers had a history of mental illness longer than 1 year. Those with a history of mental illness of less than 1 year included nine from 14 to 18 years old and four with postpartum depression. The most prevalent diagnosis was depression (40%). Referral forms indicated that 32% of all consumers were considered to have suicide ideation or suicidal intent at the time of referral. Users indicated that the technology was considered easy to use, and the quality of the sound and picture were appropriate for the application. Survey data suggested strong acceptance and satisfaction by consumers, service providers, and psychiatric consultants. Benefits perceived by consumers included timeliness of service, service in their own community with no travel-related stressors, decreased work time loss for self or family, and positive outcomes as a result of psychiatrist expertise.