Telepsychiatry in South Africa – present and future

Abstract

Telepsychiatry is one of the most longstanding telemedicine disciplines, having started over a century ago with the inception of the telephone; its modern form dates from about 1960.Telepsychiatry uses information and computer technology for diagnosis, therapy, follow-up, forensic purposes, pharmacotherapy management, psychiatric education, etc. Telecommunication links between a remote site and another to which a request/referral is made, allow data transfer (e.g. of videoconferencing images, history, reports and teaching material). Links range from telephone lines to rapid-transfer wireless links. Two or more persons at different locations (typically, a psychiatrist and a patient) most frequently use interactive videoconferencing for the provision of psychiatric expertise not otherwise available at the sender's (i.e. patient's) location. Enormous progress in telepsychiatry and all forms of telemedicine has been made recently, owing to rapidly decreasing costs of computing power, and larger data transfer capacity and storage, which allow telepsychiatry to provide unprecedented access to mental health services, and especially in rural areas. 1 Videoconferencing v. face-to-facePsychiatry is so firmly associated with face-to-face interaction that telepsychiatry's successes are insufficiently appreciated. Applications of telepsychiatryTelephonic interaction has a long history in telepsychiatry, and still remains important, as recent studies in the USA attest. In one report, 15% of such calls were 'urgent' and 1.5 % were 'emergencies'. In the UK (and many other countries, including Attitudes of patients and the providers of psychiatric services are discussed, and a short account is given of the place of tele-education in psychiatric teaching. The advantages of telepsychiatry are outlined and its limitations are discussed.Lastly,the limited experience and relevance of telepsychiatry in South Africa (and hence for other developing countries)are presented. The conclusion is that telepsychiatry is well established, its successes documented, and that it should be applied in planning future public health services in South Africa.articles

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

“…Seven reviews were excluded. Reasons for exclusion of reviews were: no quantitative systematic review process (n=3) 14,33,40 , a narrative review (n=1) 41 and non-focused videoconferencing interventions (n=3), namely an e-therapy systematic review on internet therapy 42 , a safety systematic review of telephone support 43 , and evidence based interventions for children and adolescents. 29 There was very good agreement between reviewers with a Kappa 0.9 [95% CI, 0.6-0.1].…”

“…[26][27][28] In addition, there are only a handful of reported telepsychiatry papers from the developing world [29][30][31][32] and only one reported out of Africa. 33 Before considering the implementation of telepsychiatry in South Africa, it is important to assess the existing evidence for telepsychiatry before making recommendations for the application of telepsychiatry to this environment 34 based on the level of evidence found.…”

Prevalence and Risk Factors of Violence among Preparatory and Secondary School Students in Dubai

“…While, in another systematic review, the researchers found that 21 (58%) of the studies found outcomes were not significantly different (Wade, Karnon, Elshaug, & Hiller, 2012). Wynchank and Fortuin (2010) in their study elucidated that comparisons between VC versus face -to-face intervention show similar success rates for cognitive behaviour therapy and psychotropic medication administration. Moreover, the researchers explained that telepsychiatry is favored in compliance for both the medication plan and follow-up appointments.…”

“…Telepsychiatry is comparable to conventional treatment in outcomes, and it is time and cost savings, since lessto-no travelling is required (Alcala, Munoz & Fierro, 2013;Wynchank & Fortuin, 2010;Deslich, Stec, Tomblin, and Coustasse, 2013;Richardson, Frueh, Grubaugh, Egede, & Elhai, 2009). Interestingly, Doolittle, Spaulding, and Williams (2011) in their longitudinal study demonstrated that utilization of telepsychiatry led to a 40 percent reduction in costs, further, Spaulding et al (2010) in their cross-sectional study found that utilization of telepsychiatry led to a 70 percent reduction in costs.…”

“…Most patients of all ages, from children to geriatrics, gave telepsychiatry high levels of satisfaction (Wynchank & Fortuin, 2010;Sharp, Kobak, & Osman, 2011;Trondsen, Bolle, Stensland, & Tjora, 2012). Due to its acceptance, school systems have begun to use counseling services for school-aged children while they are on their school's campus.…”