Introduction
Telemedicine is the utilization of information and communication technology for the provision of health care services in which the patient and the care giver are at different locations. It eliminates the distance barrier in the provision of medical services. (Dial Doctors, 2011)
Advantages of telemedicine include the provision of health care to locations that are not easily accessible to the care giver. For example, remote places would be able to get good medical advice when they need them with the use of telemedicine. Patient outcomes are also improved because of unhindered access to patient. Also, the frequency of doctor visits to patients is also increased so that the doctor can perform other duties while still tending to patients through telemedicine. Also, specialists who are not readily available because of distance are available through telemedicine. Telemedicine also facilitates the consultation of patients in the comfort of their homes. (Dial Doctors, 2011)
The Burden of Mental Illness
The United States and France have the highest proportion of prevalence of depression in the world. In the United States, 25% of adults (about 60 million individuals) have depression every year (Sarasohn-Kahn, 2012). Also, low level of income doubles the risk of developing depression. Also race is also a determining factor, with the non-white population having the larger share of sufferers of depression. The Economic importance of depression is such that significant number of days is lost by individuals who have mental illness. These lost days are even greater than that caused by other chronic medical conditions like asthma, diabetes and arthritis. Direct annual cost to employers is estimated to be between $80 billion and $100 billion (Sarasohn-Kahn, 2012).
The Problem
There is also an acute shortage of mental health providers. These include psychiatrists, psychologists, psychiatry nurses, social workers, family therapists and marriage therapists. This shortage is more evident in rural areas and also the children and elderly account for a large percentage of the underserved. Also, as the demand for psychiatrists continue to grow and the population of psychiatrists continues to age, fewer medical students are taking up careers in the specialty. The same goes for nurse practitioners and community based councilors (Sarasohn-Kahn, 2012).
Individuals may fail to seek medical treatment for mild or moderate depression for several reasons. One of such reasons would be the social stigma associated with depression. Also the lack of insurance coverage for mental health can also be a factor. Moreover, the refusal of the patient to use psychoactive medications can also hamper care. A concept called "Computer-Based Cognitive Therapy" may be one of the possible solutions to breaking all the barriers to treatment (Sarasohn-Kahn, 2012).
Solutions
Computer-Based Cognitive Behavioral Therapy utilizes the internet to apply coaching patterns in programs that can either be self-driven or even provider-assisted. Advancement in technology has made it possible for the design of computer systems that are able to replicate certain aspects of Cognitive Behavior Therapy that can be used in the management of a number of health issues (Sarasohn-Kahn, 2012).
Another solution to the problem of not seeking help would be counseling via e-mail, chat or video conferencing with a professional. This method has been in growing demand in recent times and the application of this method is gaining more ground (Sarasohn-Kahn, 2012).
Also, social networks can be created online which would serve as a support group for groups of individuals going through similar situations and who need similar therapy. It will be of invaluable contribution if these individuals can get support from their peers who are going through the same thing as they are (Sarasohn-Kahn, 2012).
Moreover, the development of mobile apps that individuals can use for self-management and the provision of support is also one of the ways by which this barrier can be overcome (Sarasohn-Kahn, 2012).
Also, with the level of today's computer technology, it is not out of place to develop environments of virtual reality which can be utilized in the diagnosis of conditions and even offer treatment options (Sarasohn-Kahn, 2012), (McLaren, 2003).
Overall, Behavioral Health telemedicine also has the potential of reducing the cost of healthcare. It has actually been proven to reduce the cost of healthcare by reducing cost inured by both patient and health care providers in travelling to see each other. Also shorter hospital stays would reduce the cost of hospitalization (McLaren, 2003).
Moreover, it has also been proven that the quality of healthcare delivered via telemedicine channels is not diminished in any way. There is also greater patient satisfaction in some cases in which stigmatization is attached to certain health conditions (McLaren, 2003).
It is important to note that as good as the concept of Behavioral Health Telemedicine sounds, there are still challenges needs to be overcome if this model of health care is to be implemented seamlessly (McLaren, 2003).
Access to the appropriate technology is still a challenge. 20% of Adult Americans do not have access to online technology. By implication, this means that this population is automatically excluded from utilizing Telemedicine technologies. Moreover, the technology divide is greater in the remote rural areas where utilization of the internet and its technologies cannot be compared to that which is obtained in the urban areas. It has been said earlier that access to remote rural areas is one of the reasons for advancing the Telemedicine model. The paradox, however, is that these rural areas are also deficient in technology (McLaren, 2003).
High speed internet connectivity is needed to seamlessly implement Behavioral Health Telemedicine. It is important to ensure that this is implemented in order to improve the effectiveness of Telemedicine.
The issue of funding is a complex issue that also needs to be addressed. The issue of who pays for the service and what percentage contribution an individual pays as part of the service need to be simplified as much as possible so that the scheme will be made attractive to many people. The reimbursement and remuneration of professionals also need to be standardized in order to attract more professionals to embrace the model of health care.
In conclusion, Behavioral Health Telemedicine will no doubt improve access to health care services to patients that reside in remote locations. This will increase the proportion of patients that have access to mental health care and will allow them to have professional help wherever they are. This will also reduce the need for the professional to travel to remote areas before they can attend to the health care needs of patients. This improved access is also good for the professional as it would help the professional to expend their services beyond the reach of their offices. Also, this would be a temporary way of counteracting the effect of shortage of mental health professionals.
Behavioral health Telemedicine offers huge potentials for a large number of people who need health interventions, but who cannot be reached because of one reason or the other. Telemedicine offers the solution. The problems stated above also needs to be addressed in order to make the model more attractive and more desirable to people.
REFERENCES
Dial Doctors (2011). 50-word Answers to your 6 Telemedicine Questions. Doctor's Corner; A blog by Dial Doctors. http://blog.dialdoctors.com/50-word-answers-to-your-6-telemedicine-questions/
J Sarasohn-Kahn (2012). The Online Couch: Mental Health Care on the Web. California HealthCare Foundation. retrieved on 17th August, 2013 from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OnlineCouchMentalHealthWeb.pdf
P McLaren (2003). Telemedicine and Telecare: What Can it Offer Mental Health Services?. Advances in Psychiatric Treatment (2003), vol. 9, 54–61. Retrieved on 17th August, 2013 from http://apt.rcpsych.org/content/9/1/54.full.pdf
