The Digital Revolution in Behavioral Health

Abstract

BACKGROUND: Technology is disrupting every modern industry, from supermarkets to car manufacturing, and is now entering the health care space. Technological innovations in psychiatry include the opportunity for conducting therapy via two-way video conferencing, providing electronic consultations, and telementoring and education of community health care providers. Use of mobile health applications is also an expanding area of interest and promise. OBJECTIVE: The purpose of this article is to review the evolution and pros and cons of technology-enabled health care since the digital movement in psychiatry began more than 50 years ago as well as describe the University of Rochester’s innovative digital behavioral health care model. METHODS: A review of the literature and recent reports on innovations in digital behavioral health care was conducted, along with a review of the University of Rochester’s model to describe the current state of digital behavioral health care. RESULTS: Given the lack of access to care and mental health professional shortages in many parts of the United States, particularly rural areas, digital behavioral health care will be an increasingly important strategy for managing mental health care needs. However, there are numerous hurdles to be overcome in adopting digital health care, including provider resistance and knowledge gaps, lack of reimbursement parity, restrictive credentialing and privileging, and overregulation at both the state and federal levels. CONCLUSIONS: Digital health innovations are transforming the delivery of mental health care services and psychiatric mental health nurses can be on the forefront of this important digital revolution.

Telemedicine in the United States: An Introduction for Students and Residents

“…Even fields that traditionally have depended on face-to-face communications, such as psychiatry, have been able to provide care of comparable quality using telemedicine. As of 2016, a mere 43.1% of the 44.7 million Americans with any sort of mental illness had used mental health services in the United States [10]. Being able to provide care to more Americans with mental illness through telepsychiatry could have a profound effect.…”

“…Being able to provide care to more Americans with mental illness through telepsychiatry could have a profound effect. The University of Rochester in Rochester, NY, USA created a telepsychiatry program that is available from 8:30 AM to 5:00 PM, Monday through Friday, and is performing about 2000 telepsychiatry consultations per year [10]. A provider simply sends a request for a visit with a patient by computer, and the query is answered by a specialist at the university.…”

“…The interface of communication is extremely simple, consisting of an iPad on a rolling stand for providers and a video camera for the patient. Nurses are also able to use the interface to record videos of patients in agitated states and securely send the videos to specialists, who can use a patient's video and medical record to recommend treatment and calming techniques [10].…”

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis

“…From 2005 to 2012, a state tertiary pediatric hospital in Western Australia provided remote treatments to 1312 children with burns [ 25 ]. The University of Rochester has established a telemedicine platform for the treatment of mental illness that conducts about 2000 telepsychiatric consultations per year [ 26 ]. In the United States, 15 million people were supported by telemedicine in 2015, an increase of 50% compared with the number in 2013 [ 27 ].…”

Development of a Telepsychology Program for Parents of Pediatric Patients

“…Telepsychology, also known as telemental health, refers to the delivery of behavioral health services via telecommunication systems, including video-based technologies (Aboujaoude et al, 2015). The recent surge in telepsychology has revolutionized mental health care delivery by expanding access to care, enhancing care efficiency, and reducing health expenditure costs (Aboujaoude et al, 2015; Godleski et al, 2012; Hasselberg, 2020). Although telepsychology approaches have been around for decades and are rapidly growing, the understanding, appreciation, and comfort with using these interventions remain underdeveloped.…”