Psychiatry via televideo an answer to specialist shortage?
Date: Aug. 3, 1999
Time: 3:01 pm
Time and distance are 2 of the barriers that have hindered physicians' ability to provide consistent health care across the country. However, these 2 constants may no longer be a paramount factor in the delivery of psychiatric care and counselling, results from a pilot study involving "televideo" psychiatry indicate.
The study, which involved 2 mental health centres, was coordinated by Dr. Gene Duplessis of the Campbellford and District Community Mental Health Centre, which is located near Peterborough, Ont., and Dr. John Farewell of Toronto's Centre for Addiction and Mental Health.
"There were 40 patients involved, recruited from family practices in the Campbellford area," explains Farewell. "All the patients involved were 18 years of age or older and needed general psychiatric assessment. None of the patients involved were actively suicidal. Twenty of the patients were assessed through a face-to-face, 90-minute interview, while the other half were assessed for the same length of time via televideo."
What distinguishes this study from others is the real distances involved. In most previous studies of the value and effectiveness of televideo, the psychiatrist and patient were separated only by a wall. With this recent Ontario study, however, the psychiatrist and patient were separated by 2.5 hours of highway.
Feedback provided by both patients and psychiatrists indicated that both parties had no problem developing the rapport that characterizes the doctors–patient relationship, and that there was little difference in the psychiatric assessments and solutions found in the 2 groups. Some of the patients felt an initial trepidation because of the television screen, but it was soon forgotten.
If this technology is eventually adopted, then there will have to be a change in the way psychiatrists are paid. Currently, the Ontario Health Insurance Plan only covers the cost of face-to-face consultations, which excludes televideo consultations.
Farewell and Duplessis are encouraged by the initial results and are confident that televideo will eventually become a common tool for delivering psychiatric services across Ontario. They think the technology may help alleviate the shortage of consistent psychiatric care across the province. -- Peter Wilton, Toronto
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