Chapter 13.Telepsychiatry

The practice of telepsychiatry—typically defined as the use of videoconferencing to perform psychiatric consultations—is almost 60 years old. At last, the technical and economic barriers that have slowed the adoption of telepsychiatry have almost disappeared with the advent of Web- and cloud-based systems, mobile computing, the impact of commercial telemedicine service companies, and a growing body of evidence and telepsychiatry research. Now we can see patients securely (in compliance with the Health Insurance Portability and Accountability Act [HIPAA]) and in high definition on a laptop or tablet at minimal cost using video systems that currently run well in parallel with most electronic medical records but that will doubtless be integrated into them in the near future. The opportunity for mental health professionals to engage in brief psychotherapy via telepsychiatry has already benefited many thousands of patients. The future will likely bring many psychiatrists working increasingly in a hybrid model, both in person and online, using the strengths of both approaches to improve patient care. Technologies are gradually changing the psychiatrist-patient relationship, softening its boundaries and making it more of an “anytime, anywhere” collaborative partnership, something that will be especially helpful when practicing the range of brief psychotherapies.