Considerations for Telepsychiatry Service Implementation in the Era of COVID-19

April 2020

Telepsychiatry, or the use of technology to provide mental health services, has increasingly been studied to meet the growing demand for psychiatric care. Moreover, telepsychiatry has been implemented in various settings to address barriers to accessing psychiatric care, including shortages in mental health clinicians, remote geographic locations, social stigma related to initiating care in a mental health setting, limited mental health parity, and fragmented systems of care. The utility of telepsychiatry is relevant now more than ever, as the world endures a global pandemic and as mental health professionals seek ways to initiate and continue much-needed mental health services. For instance, where physical distancing (people keeping at least 6 feet apart) is necessary to prevent the spread of COVID-19, telepsychiatry helps meet the demand for mental health services. This benefit is of particular salience during the COVID-19 pandemic, as many clinics pare down their onsite mental health workforce to enhance safety of staff and patients.

This collection highlights the breadth of available telepsychiatry services, considerations for implementing telepsychiatry in various mental health settings, and billing implications. It also underscores the importance of helping patients use telepsychiatry services, understanding the toll this new platform can have on mental health providers, and offering ways to minimize burnout among telepsychiatry providers to improve outcomes for providers and patients alike. A host of telepsychiatry options are available, including services for patients with psychotic disorders, for veterans through the Veterans Health Administration system, and for people who live in rural areas. As we move through this crisis, we should do our best to implement needed telehealth interventions, maintain these services into the future, and expand the evidence base around telepsychiatry, including evaluating its impact on mental health services and patient outcomes.

Ayana Jordan, M.D., Ph.D.
Lisa B. Dixon, M.D., M.P.H.

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Types of Telepsychiatric Services

E-Mental Health: A Rapid Review of the Literature
Shalini Lal, Ph.D., and Carol E. Adair, Ph.D.
2014, Volume 65, Issue 1, pp. 24–32


E–Mental Health Self-Management for Psychotic Disorders: State of the Art and Future Perspectives
Lian van der Krieke, M.Sc., M.A., Lex Wunderink, M.D., Ph.D., Ando C. Emerencia, M.Sc., Peter de Jonge, Ph.D., and Sjoerd Sytema, Ph.D.
2014, Volume 65, Issue 1, pp. 33–49


Using Telehealth to Implement Cognitive-Behavioral Therapy
Loren Dent, Ph.D., Aimee Peters, L.C.S.W., Patrick L. Kerr, Ph.D., Heidi Mochari-Greenberger, Ph.D., M.P.H., Reena L. Pande, M.D., M.Sc.
2018, Volume 69, Issue 4, pp. 370–373


The Use of Telepsychiatry to Provide Cost-Efficient Care During Pediatric Mental Health Emergencies
John F. Thomas, Ph.D., Douglas K. Novins, M.D., Patrick W. Hosokawa, M.S., Christina A. Olson, M.D., Dru Hunter, L.C.S.W., Alison S. Brent, M.D., Gerard Frunzi, M.B.A., Anne M. Libby, Ph.D.
2018, Volume 69, Issue 2, pp. 161–168


An Experimental Comparison of Telepsychiatry and Conventional Psychiatry for Parolees
David Farabee, Ph.D., Stacy Calhoun, M.A., Robert Veliz, M.P.H.
2016, Volume 67, Issue 5, pp. 562–565

Design & Implementation of Telepsychiatry

Telepsychiatry Use in U.S. Mental Health Facilities, 2010–2017
Stanislav Spivak, M.D., Amethyst Spivak, J.D., Bernadette Cullen, M.B., M.R.C. Psych., Jennifer Meuchel, M.D., Deirdre Johnston, M.D., Rachel Chernow, L.C.P.C., Charee Green, L.C.P.C., Ramin Mojtabai, M.D., Ph.D.
2020, Volume 71, Issue 2, pp. 121–127

Featured in our Alexa Flash Briefing, Psychiatric News Brief.


Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services
Alejandro Interian, Ph.D., Arlene R. King, Ph.D., Lauren M. St. Hill, B.S., Claire H. Robinson, M.P.H., Laura J. Damschroder, M.S., M.P.H.
2018, Volume 69, Issue 1, pp. 69–75


A Description of Telemental Health Services Provided by the Veterans Health Administration in 2006–2010
Tisha L. Deen, Ph.D., Linda Godleski, M.D., and John C. Fortney, Ph.D.
2012, Volume 63, Issue 11, pp. 1131–1133


Increasing Mental Health Care Access, Continuity, and Efficiency for Veterans Through Telehealth With Video Tablets
Josephine C. Jacobs, Ph.D., Daniel M. Blonigen, Ph.D., Rachel Kimerling, Ph.D., Cindie Slightam, M.P.H., Amy J. Gregory, B.A., Tolessa Gurmessa, M.D., M.S., Donna M. Zulman, M.D., M.S.
2019, Volume 70, Issue 11, pp. 976–982


An Innovative Approach to Care: Integrating Mental Health Services Through Telemedicine in Rural School-Based Health Centers
Taniya Pradhan, M.B.B.S., M.D., E. Ashley Six-Workman, B.S.N., R.N.-B.C., Kari-Beth Law, M.D.
2019, Volume 70, Issue 3, pp. 239–242

Also featured in the Rural Mental Health collection.

Use of Tele–Mental Health in Conjunction With In-Person Care: A Qualitative Exploration of Implementation Models
Lori Uscher-Pines, Ph.D., Pushpa Raja, M.D., Nabeel Qureshi, Haiden A. Huskamp, Ph.D., Alisa B. Busch, M.D., Ateev Mehrotra, M.D.
2020, Volume 71, Issue 5, pp. 419–426


Using Continuous Quality Improvement to Design and Implement a Telepsychiatry Program in Rural Illinois
Hossam Mahmoud, M.D., M.P.H., Emily L. Vogt, B.A., Rabih Dahdouh, M.S., Michael Luke Raymond, L.C.P.C.
2020, Volume 71, Issue 8, pp. 860–863

Also featured in the Rural Mental Health and The Psychiatric Workforce Shortage collections.

Designing an Academic-Community Telepsychiatry Partnership to Provide Inpatient and Outpatient Services in a Critical Access Hospital
Ryan J. Kimmel, M.D., Matthew D. Iles-Shih, M.D., M.P.H., Anna Ratzliff, M.D., Ph.D., Cara Towle, R.N., M.S.N.
2019, Volume 70, Issue 8, pp. 744–746


Rural-Nonrural Differences in Telemedicine Use for Mental and Substance Use Disorders Among Medicaid Beneficiaries
Timothy B. Creedon, Ph.D., Kristin E. Schrader, M.A., Peggy L. O'Brien, Ph.D., Janice R. Lin, B.S., Christopher D. Carroll, M.Sc., Norah Mulvaney-Day, Ph.D.
2020, Volume 71, Issue 8, pp. 756–764

Also featured in the Rural Mental Health collection.

Billing and Utilization

Assessing Telemedicine Utilization by Using Medicaid Claims Data
Megan Daugherty Douglas, J.D., Junjun Xu, M.P.H., Akilah Heggs, M.A., Glenda Wrenn, M.D., M.S.H.P., Dominic H. Mack, M.D., M.B.A., George Rust, M.D., M.P.H.
2017, Volume 68, Issue 2, pp. 173–178

Also featured in the Rural Mental Health collection.

Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United States
Fernando A. Wilson, Ph.D., Sankeerth Rampa, Ph.D., Kate E. Trout, Ph.D., Jim P. Stimpson, Ph.D.
2017, Volume 68, Issue 12, pp. 1303–1306

Special Considerations for Telepsychiatry

When Will Telepsychiatry Reach Its “Tipping Point”?
Michael A. Flaum, M.D.
2017, Volume 68, Issue 12, pp. 1205–1205


Telepsychiatry: Implications for Psychiatrist Burnout and Well-Being
Emily L. Vogt, B.A., Hossam Mahmoud, M.D., M.P.H., Omar Elhaj, M.D.
2019, Volume 70, Issue 5, pp. 422–424

Also featured in the Resilience collection.

Telemedicine for Mental Health in the United States: Making Progress, Still a Long Way to Go
Michael L. Barnett, M.D., M.S., Haiden A. Huskamp, Ph.D.
2020, Volume 71, Issue 2, pp. 197–198

Also featured in the Rural Mental Health collection.

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