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Elders in the Spotlight: Study shows effectiveness of telepsychiatry among senior citizens

Jan. 9, 2014

Because of Alaska’s vast distances, federal, state, tribal, private and military medical care providers have long been enthusiastic users of telecommunications. Now, long-distance psychiatric care is on the rise, a practice health officials say allows more people access to the care they need. 

Ron Hale is acting CEO of the Anchorage-based Alaska Psychiatric Institute. He  says for several years, API has been using video-conferences to link patients in rural Alaska with social workers, psychologists and psychiatrists in Anchorage, an approach he says helps patients avoid the stress and expense of traveling to urban centers for treatment:

So I think just the transportation costs, and then all the other unintended costs that go along with that, traveling through Alaska [are a problem],” says Hale. “You’re out of your village. You have costs if someone travels with you. You have food and lodging. There’s all sorts of things that you save. And it makes care accessible. I’m sure it keeps people out of the hospital.”

Hale says API psychologists work with people with a spectrum of mental illnesses such as schizophrenia, anxiety, bi-polar disorder, and post-traumatic stress disorder.

Associate Professor Dr. Bonnie Kenaley of Boise State University in Idaho says a survey of studies on telepsychiatry for the most part show it to be as effective as in-person sessions, and particularly helpful with people who cannot access mental health care due to disability or lack of transportation. She recently completed a study on telepsychiatry and 115 older adults with depression, and with heart failure or chronic pulmonary disease. All of them are homebound, she says, but not in a nursing home or assisted living.

“If we can keep them at home, we can keep them less depressed,” says Kenaley. “ We can make them feel more productive, have them empowered, then more able to take care of themselves, isn’t that a wonderful thing.”

She says researchers looked at changes in the clients’ mental state over a year as an intervention team, called an I-Team, taught the seniors stress relief and problem-solving strategies through videoconferences.

“It actually increases their sense of autonomy, and decreases their depression, and increases their mental functioning,” says Hale. “Now we haven’t seen that it increases their physical functioning but certainly their mental functioning. It decreases their emergency room visits, which certainly that decreases the amount of money spent at the emergency room. “

Hale says telepsychiatry opens the way for more people to get the care they need for mental illness.

“I think you’re going to see more and more of it. I think Alaska’s a well-connected state. There’s opportunities for, not just behavior health, but for all types of practices. And I think in the long run, it’s going to do the state and patients a lot of good, telemedicine, get larger and larger. It’s a good time to be here.”

State and nonprofit organizations such as the Alaska e-health Network and the Alaska Tele-health Advisory Council, are working to set telemedicine standards, increase efficiency and security, and to plan and fund the expansion of telehealth.

Joaqlin Estus reported this story through a MetLife Foundation Journalists in Aging Fellowship, a project of New America Media and the Gerontological Society of America.