Video-based mental health therapy plays a vital role by bridging the treatment gap for children who have little access to psychiatric care, according to a new study at the University of Missouri School of Medicine. The researchers found that most patients who choose this form of “tele-psychiatry” come from rural counties and other underserved areas.
Only 20 percent of children in the U.S. with behavioral issues will receive any mental health care, according to the American Academy of Child and Adolescent Psychiatry. Of those who do receive care, approximately half drop out of therapy early due to hardship issues such as lack of access, lack of transportation, and financial constraints.
In rural states such as Missouri where almost 40 percent of the population lives outside urban areas, children usually have even less access to timely psychiatric care.
“One of the biggest health care issues we as a nation face is a physician shortage in pediatric and adolescent behavioral health,” said lead author Mirna Becevic, Ph.D., an assistant research professor of telemedicine at the University of Missouri School of Medicine.
Becevic goes on to explain that, in 1990, the Council on Graduate Medical Education, a committee of the Department of Health and Human Services, advised that by the year 2000, there would be a need for 30,000 child and adolescent psychiatrists.
However, today only about 8,300 physicians specialize in child and adolescent psychiatry. This shortage not only affects youth in rural locations, but children in all underserved areas, she says.
For the study, the researchers analyzed data from July 2013 to May 2014 and calculated the distance between each patient and the nearest child and adolescent psychiatrist. They wanted to better understand which patients choose long-distance psychiatric services through University of Missouri ‘s Missouri Telehealth Network.
The findings show that 179 patients from 19 ZIP codes, mostly in rural areas, made 662 appointments for psychiatric services using the Missouri Telehealth Network. The average patient age was 16.
“Not surprisingly, the majority of Missouri physicians are located in urban areas along Interstate 70,” Becevic said. “Although there are child and adolescent psychiatrists in other areas of the state, many rural counties have none.”
Researchers identified 13 physicians specializing in child and adolescent psychiatry in Kansas City, 24 in Columbia and 42 in St. Louis. Another 42 child and adolescent psychiatry physicians were based in other parts of the state. Without the option of tele-psychiatry, the average distance a patient would have had to travel for care was 22.2 miles. The furthest distance would have been more than 300 miles.
The study of access to psychiatric services was limited to the extent that researchers only analyzed appointments made through the Missouri Telehealth Network.
“Our findings indicate that there is limited access to child and adolescent psychiatric services in our state,” Becevic said. “More important, our study illustrates how remote populations have severe barriers to access. The mental health shortage, especially in rural areas, is not a new discovery. However, this study highlights the severity of the need for mental health services in our state, especially for children and adolescents.”
Becevic said that future studies will include specific diagnoses by location, as well as the extent of psychiatry use from other telemedicine sources.
The study is published in The Journal of Health Management.
Source: University of Missouri-Columbia