Telehealth Increases Access to Care for Children Dealing with Suicidality, Depression, and Anxiety in Rural Emergency Departments

Abstract

Background: Targeted research efforts in implementation and evaluation of telemental health care for U.S. youth are needed to increase accessibility to care. Before telehealth, children and families may wait weeks for psychiatric evaluation.

Adaptation of evidence‐based suicide prevention strategies during and after theCOVID‐19 pandemic

“…Barriers that limit the use of telemedicine include the lack of access to the Internet 198 , the required electronic devices, or the technological capabilities of recipients, especially individuals in old age or with serious mental health illnesses 199 . The coverage of telemedicine through insurances may be limited 200 , and integration into the health care systems is required to ensure the broad availability of digital medical services to the population 201,202 .…”

An Observational Study of Telemental Care Delivery and the Context for Involuntary Commitment for Mental Health Patients in a Group of Rural Emergency Departments

“…The Wabash Valley Rural Telehealth Network (WVRTN) serves some of the state's most economically disadvantaged and medically underserved counties in Indiana. Based on previous research studies, 9,10,23,24 increasing number of patients and families in the targeted region are self-reporting the need for MH care. For this evaluation, characteristics that may impact telemental health care delivery in the participating rural EDs are reported for youth and adult participants of ages 6-65+ years.…”

“…Mean wait time for IC patients was 19 min (95% CI [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]), with a range of 7 min (95% CI [3][4][5][6][7][8][9][10][11]) for SA patients to 35 min (95% CI ) for anxiety, depression, and other mental illness patients, a statistically significant difference ( p = 0.045). Mean wait time for IC patients brought to ED by law enforcement was shorter on average than for nonforensic patients, with time-toprovider averaging 11 min (95% CI [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]) compared with 20 min (95% CI ), respectively. Mean wait time for non-IC patients was 23 min (95% CI [19][20][21][22]…”

“…1,2,8 The importance of telemental health in rural settings If a psychiatric consult with an MH specialist is not immediately available, rural MH patients may be sent home to wait for days, weeks, or even months for their initial evaluation by a psychiatric specialist. 1,[7][8][9][10] The implementation of MH care delivered through telehealth, or telemental health, serves to provide effective and expedient access 6,7 to psychiatric evaluation that is similar in efficacy to face-to-face care. [6][7][8]11,12 Telemental care delivery has been reported to level the playing field in rural settings, so that the major social determinants of health (ready access to care, geographic location, health insured status, and socioeconomic disparities) are addressed to foster more efficient and effective care.…”

“…[6][7][8]11,12 Telemental care delivery has been reported to level the playing field in rural settings, so that the major social determinants of health (ready access to care, geographic location, health insured status, and socioeconomic disparities) are addressed to foster more efficient and effective care. [8][9][10][11][12] Implementation of telehealth has also been shown to decrease rural patients' ED wait time and length of stay (LOS). 8,9,11,13,14 Current state regulations permit use of telehealth for MH services in 30 U.S. states, and for substance use disorder services in 21 U.S. states.…”