The use of telemedicine to deliver services to patients with severe mental illness (SMI) is promising, but does not necessarily improve medication uptake rates. It remains unclear whether an expansion of these services would improve the quality of care.
Among other things, these were the results of a cohort study published in JAMA network openas of June 27, this included 118,670 patients with schizophrenia or related psychotic disorders and/or bipolar I disorder in non-metropolitan counties.
The study found that the use of telehealth services improved patient follow-up by healthcare professionals after hospitalization, along with a “modest increase” in contact with outpatient mental health specialists.
“However, no significant changes in medication adherence were observed and an increase in hospital admissions was observed,” the report said.
The increase in hospital admissions does not necessarily mean that the use of telemedicine leads to poorer care and ends in a hospital visit, the report warned, rather the use of telemedicine enables healthcare professionals to correctly identify and treat patients with an acute crisis stabilize.
WHY THIS MATTERS
As healthcare becomes more distributed, patients have more opportunities to seek medical care outside of traditional healthcare systems.
However, this access to multiple channels of care has created a new problem: the virtual fragmentation of healthcare. Community health centers have turned to telemedicine to improve their services.
While the use of telehealth or telemedicine technologies has been evolving rapidly due to the pandemic, research regarding the use of specialized mental health care and medication adherence through telemedicine technology is limited.
In rural areas, access to specialized care remains a challenge for patients with severe mental disorders, the report said. There is currently a lively discussion in many federal states as to whether the temporary expansion of telemedicine caused by the pandemic should be extended to the care of mental illnesses.
Other digital services, including the use of tablets, have helped bring mental health programs to patients in rural areas.
According to another study published inJAMA network openproviding a video-enabled tablet to veterans living in rural areas reduced emergency room visits and suicidal behaviors.
THE BIGGER TREND
Research compiled in 2018 had previously described the feasibility of using telemedicine in the treatment of schizophrenia and psychotic disorders.
According to Trilliant Health’s trend analysis, which focused on telemedicine use in the United States between March 2020 and November 2021, about a quarter of Americans used telemedicine during COVID-19.
However, other researchers have found that therapists deal with a higher percentage of clients from groups with lower socioeconomic status, patients on Medicaid, and families are less likely to continue using telemedicine after the pandemic.
According to the report, the use of telemedicine for behavioral health is also increasing. However, new digital health tools provided by retailers such as Amazon and Walmart, as well as device offerings from Apple, Google and a number of start-ups could lead to more sophisticated and effective telehealth offerings across a wide range of care.