S23: Evaluation and Implementation of a Tele-Psychiatry Trial in the Emergency Department of a Suburban Public Hospital

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By September 21, 2017 No Comments

Authors: Euan Donley, Ainslie McClaren, Robyn Jones, Paul Katz, Joyce Goh

Year: 2017

Event: 2017 TheMHS Conference

Subject: Suicide Prevention,Change, Innovation, Reform, Technology, e-health, Research & Evaluation Informing Practice

Type of resource: Conference Presentations and Papers

Abstract: Tele-psychiatry via video conferencing is not new to mental health but has been expanding at a rapid rate over recent years. Initially it was introduced to treat remote and rural communities, but is now being utilised in larger health settings due to increasing patient demand and cost effectiveness. Emergency Departments are becoming increasingly burdened as the workforce cannot keep pace with the rising demand of mental health patient needs. While tele-psychiatry has been shown to have treatment efficacy, research is still relatively new, especially within the Emergency Department context.

This mixed methods study examined the experiences of 44 participants from both clinical and patient perspectives in the Emergency Department. The trial examined rates of satisfaction and general sustainability of tele-psychiatry in the Emergency Department. Not all types of mental health presentations were deemed appropriate for tele-psychiatry, however, of those included results indicate generally a positive experience. Participants reported feeling; satisfied with assessment, well-informed of the benefits and risks of tele-psychiatry assessment, did not feel greatly disadvantaged by not having a face to face assessment, would be happy to participate in another tele-psychiatry assessment if required, and no adverse events were recorded. There were some technological issues such as clarity of audio in a loud department, and on occasion a perception that rapport was impacted slightly. Tele-psychiatry did reduce waiting times which was cost effective, however, this may be due to the types of presentations suitable to tele-psychiatry.

While the results of this pilot study are encouraging, further research is required into the use of tele-psychiatry in the Emergency Department, especially with patients presenting as acutely unwell and distressed. If tele-psychiatry is to be successful then leadership, consultation and co-ordination is required giving consideration to all infrastructure, participant, industrial, technological and environmental factors.

Learning Objectives
Learning Objective 1: The audience will gain an understanding of; why EDs may need to utilise tele-psychiatry, how it can be implemented, the results of this trial, the implications for practice, benefits and limitations, and areas where further research is required.

Learning Objective 2: Tele-psychiatry has been utilised for mental health for many years, and as ED patient numbers continue to rise with limits on resourcing, tele-psychiatry will likely be standard practice in many instances in the years to come. This study was at the forefront of acute ED mental health services involving assessment and treatment of mental health patients in crisis.

Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The Effectiveness of Telemental Health: A 2013 Review. Telemedicine Journal and E-Health, 19(6), 444–454. http://doi.org/10.1089/tmj.2013.0075
Shore, J. H., Hilty, D. M., & Yellowlees, P. (2007). Emergency management guidelines for telepsychiatry. General hospital psychiatry, 29(3), 199-206.

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