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Home » Telepsychiatry

Psychiatric Times. Vol. 28 No. 5
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CLINICAL 

A Literature Review of Videophone Use in Mental Health

A Tool That Can Enhance Patient Convenience, Safety, and Satisfaction

By J. Edwin Nieves, MD, Gregory Briscoe, MD, Lucinda Edwards, MLS, and Aidith Flores-Carrera, DO | June 8, 2011
Dr Nieves is associate chief of staff for education and associate professor of psychiatry and behavioral sciences at the Eastern Virginia Medical School in Norfolk. Dr Briscoe is professor of psychiatry and behavioral sciences at the Eastern Virginia Medical School and staff psychiatrist at the Veterans Administration Hospital in Hampton, Va. Ms Edwards is medical librarian in the department of education at the Veterans Administration Hospital. Dr Flores-Carrera is a psychiatry resident at the Naval Medical Center in Portsmouth, Va. The authors report no conflicts of interest concerning the subject matter of this article. Disclaimer—The contents of this article do not represent the views of the Department of Veterans Affairs, the Department of the Navy, or of the government of the United States.

In another study, by Passik and associates,4 dignity psychotherapy was delivered via videophone to 8 terminally ill patients in an effort to prevent depression. These patients lived in a rural area far from the local medical center.4 Although there were some minor technical problems with the videophone, patients’ mood remained stable (measured by Zung scale) throughout the sessions for an average of 31 days. The patients showed an overall preference for using the videophone compared with face-to-face sessions because of the ability to participate from their own homes.

Cluver and colleagues5 compared the efficacy of cognitive therapy delivered via videophone with that of face-to-face therapy in 10 terminally ill patients. A total of 53 sessions were carried out alternating randomly between face-to-face and videophone. Of these, 21 sessions (39.6%) used videophone and 32 sessions (60.4%) were face-to-face. Patients reported being “highly satisfied” with both videophone technology and videoconferencing.

The studies by the Passik group4 and the Cluver group5 report easy acceptance and satisfaction with videophone technology by both patients and caregivers. These studies highlight the value of videophone technology in bringing access to services right into the patient’s home.

Caregiver support

Videophones have also been used successfully to offer 12 caregivers of terminally ill patients access to an institutionally based hospice interdisciplinary team.6 The caregivers were able to participate in treatment team meetings and to discuss medications (refills/dosages) and pain management. It also allowed the treatment team members visual confirmation of patient health status (disease progression and whether or not death was imminent).6

Caregiver support and psychiatric morbidity prevention have also been accomplished using videophones in a cohort of 61 patients with spinal cord injuries and their caregivers in rural areas of 3 southeastern states.7 Caregivers were supported with problem-solving interventions via videophones. The goal was to prevent caregivers from becoming distressed and depressed and also to help them forestall pressure ulcers and other complications in their patients. Videophones provided visual access to health care information services and support to caregivers.

Remote mental health care access

May and colleagues8 explored the use of the videophone as a means to expedite primary care clinic referrals from a distant location to a mental health center in the United Kingdom. In this study, primary care providers used a videophone to refer anxious or depressed patients to a mental health provider. Mental health providers evaluated the patient using a videophone, made an initial diagnosis and management recommendations, and then subsequently saw the patients face-to-face.

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