How Mental Health Has Become a Hot Topic in Telemedicine

Could the era of Internet technologies and consumer electronics boost access to mental health care? Dr. Phil McGraw and numerous other exhibitors at the 2015 Consumer Electronics Show (CES) believe so.

At the CES Digital Health Summit, television talk-show host and Doctor on Demand cofounder McGraw presented his vision of how wireless and communications technology will boost wellness and mental health. McGraw highlighted how telemedicine must play a greater role in providing mental health care, or “tele-mental” health.

“It’s hard to make that first appointment—and it’s harder to keep it,” said McGraw. “There is still a stigma when it comes to mental health. Telemedicine allows people to go past the initial hurdle.”

The rise of camera-equipped smartphones, wearable devices, fitness trackers, and smart watches has attracted the attention of academic researchers in psychiatry and commercial health technology companies. Even nonprofit organizations, such as CareMessage and Medic Mobile, provide remote depression, anxiety, and medication management programs.

Telemedicine has grown in use in dermatology, radiology, critical care, and other medical specialties, taking advantage of increasing Internet bandwidth, speed, and availability. Psychiatry is joining other medical specialties, particularly with smartphones’ ability to provide clear video and audio.

Doctor on Demand has a network of more than 300 psychologists who provide video therapy. The company also has a network of independently contracted physicians who are able to prescribe medications but not narcotics or pain medications.

It isn’t just clinicians who are interested in this idea. The website FierceHealthIT reported in early January on how telemedicine and the patient-monitoring market could grow by about $5 billion by 2020, underscoring commercial interest and venture-capital funding in the industry.

With depression, anxiety, and other comorbid psychiatric disorders taking a toll on physical health, health care providers and companies are realizing that physical health is not enough. Mental health plays a key role as well, and telemedicine can play crucial roles in integrated care consultation models and providing tele-mental health services for the unreachable.

According to Peter Yellowlees, M.D., a professor of psychiatry and director of the Health Informatics Program at the University of California, Davis, and a board member of the American Telemedicine Association, patients with social phobia, posttraumatic stress disorder, and social anxiety benefit greatly from telemedicine.

Satisfaction with telemedicine is frequently better than with in-person services, said Yellowlees of his research and clinical experience with telemedicine. “Children prefer this, along with anxious patients, paranoid patients, and people who hate driving.”

Other devices have taken on increasing emphasis in behavioral health. Exhibitors showcased neurofeedback electroencephalography devices for stress reduction and autism, along with smartphone alcohol breath analyzers and fitness trackers to measure heart rate, heart-rate variability, steps, and sleep patterns.

Telehealth platform services like HealthLinkNow, MDLive’s BreakThrough, Rock Health–funded Lantern (formerly ThriveOn), and Google’s HelpOuts also provide smartphone apps for consumers to use to connect with psychotherapists. HealthLinkNow provides support for connecting to psychiatrists.

Indeed, telemedicine can boost access and visibility for psychiatry and mental health. By giving the keynote speech at an international conference that drew more than 160,000 attendees, McGraw’s efforts boosted mental health’s importance in the digital health space. Over the past decade, this industry has emphasized physical health care. Such media presence has also helped in the efforts toward destigmatizing mental health. Notable celebrities who do similar work and have spoken at APA’s annual meeting include actor and PBS host Alan Alda, author Andrew Solomon, and former Congressman Patrick Kennedy.

As industry analysts at CES and as members of the APA Council on Communications, we felt that it was important that psychiatry be represented in digital health care and telemedicine and that we advocate for our patients who—as demonstrated in this past year’s research literature—are willing to use it to manage their mental health.

There needs to be more research, adaptation, and design of these technologies to help our most vulnerable patients, those with severe mental illnesses, and patients with low English proficiency who have scarce access to cultural and language resources. Using existing technology infrastructure can address physical barriers and the cost of replicating and providing such services.

Technology companies are increasingly realizing that patients cannot have good health without addressing mental health. And though face-to-face encounters are still at the core of psychiatry, it is not suitable—or even affordable—for many. Barriers such as cost, time, and transportation prevent those from seeking out face-to-face encounters, and telemedicine addresses this. We are optimistic that the benefits that have advanced other medical fields will also benefit psychiatry. ■