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Using Technology in the Delivery of Mental Health and Substance Abuse Treatment in Rural Communities: A Review

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Abstract

Rural communities face tremendous challenges in accessing mental health and substance abuse treatment services. Some of the most promising advancements in the delivery of rural health care services have been in the area of telecommunication technology. These applications have the potential to reduce the disparities in the delivery of substance abuse and mental health services between urban and rural communities. The purpose of this inquiry was to explore the advances and uses of telecommunications technology, and related issues, in the delivery of mental health and substance abuse treatment services within rural areas. A review of the academic literature and other relevant works was conducted and the content was organized into four major themes: (a) advantages of telehealth and applications to rural practice, (b) barriers to implementation in rural practice, (c) utilization in rural areas, and (d) areas for further research.

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References

  1. Primm AB, Vasquez MJT, Mays RA, Sammons-Posey D, McKnight-Eily LR, Presley-Cantrell LR, et al. The role of public health in addressing racial and ethnic disparities in mental health and mental illness. Preventing Chronic Disease 2010; 7(1): A20. http://www.cdc.gov/pcd/issues/2010/jan/09_0125.htm. Accessed June 11, 2012.

  2. National Association of State Alcohol and Drug Abuse Directors, Inc. Tele-health in Sate Substance Use Disorder (SUD) Services, 2009. Supported by: The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT), under the NOMS Collaborative Support Initiative, Grant # 5H79TI019551, June.

  3. Chong, J, Moreno, F. Feasibility and acceptability of clinic-based telepsychiatry for low-income Hispanic primary care patients. Telemedicine Journal and E-Health 2012; 18(4): 297–304

    Article  PubMed  Google Scholar 

  4. Thara, R. Using mobile telepsychiatry to close the mental health gap. Current Psychiatry Reports 2012; 14(3): 167–8.

    Article  PubMed  Google Scholar 

  5. Sulzbacher, S, Vallen, T, Waetzig, EG. Telepsychiatry improves pediatric behavioral health care in rural communities. Journal of Telemedicine and Telecare 2006, 12(6): 285–8

    Article  PubMed  Google Scholar 

  6. Campbell, NC, Meile, GM, Nunes, EV, et al. Web-based, psychosocial treatment for substance use disorders in community treatment settings. Psychological Services 2012; 9(2): 212–214. doi:10.1037/a0025968

    Article  PubMed  Google Scholar 

  7. Teleservices improve access to PTSD treatment. Telemedicine Journal and E-Health 2010 Jul-Aug; 16(6): 654–8, doi:10.1089/tmj.2010.9958

  8. Chung-Do J, Helm, S, Fukuda, M, et al. Rural mental health implications for telepsychiatry in clinical service, workforce development, and organizational capacity. Telemedicine Journal and E-Health 2012; 18(3): 244–6.

    Article  PubMed  Google Scholar 

  9. 2011 APA Gold Award: A telepsychiatry solution for rural eastern Texas. Psychiatric Services 2011; 62 (11): 1384–1386. doi:10.1176/appi.ps.62.11.1384

  10. Ulzen, T, Williamson, L, Foster, PP, et al. The evolution of a community based telepsychiatry program in rural Alabama- A brief report. Community Mental Health Journal 2012; doi:10.1007/s10597-012-9493-2.

  11. Edward, K. The VA Maryland health care system’s telemental health program. Psychological Services 2012; 9(2): 203–205.

    Article  Google Scholar 

  12. American Tele-medicine Association (ATA). Tele-health and health care provider shortages, position statement and recommendations. Available online at http://www.americantelemed.org/files/public/policy/Telehealth_and_the_Provider_Shortage.pdf. Accessed December 5, 2011.

  13. Center for Telehealth and E-Law. While a telehealth program can provide many benefits, attention must be paid to state and federal laws that determine what is considered a legal interaction. Available online at http://healthcare-executive-insight.advanceweb.com/Features/Articles/Telehealth-Can-Save-Time-Money.aspx. Accessed December 5, 2011.

  14. Sarasohn-Kahn, J. Tele-health beginning to go mainstream, but long road lies ahead. IHealth Newsletter 2010 June 7.

  15. Hilty, DM, Luo, JS, Morache, C, et al. Tele-psychiatry: An overview for psychiatrists. CNS Drugs 2002; 16: 527–548.

    Article  PubMed  Google Scholar 

  16. Hilty, DM, Nesbitt, TS, Kuenneth, CA, et al. Rural versus suburban primary care needs, utilization and satisfaction with telepsychiatric consultation. The Journal of Rural Health 2007; 23(2): 163–165: doi:10.1111/j.1748-0361.2007.00084.x

    Article  PubMed  Google Scholar 

  17. Hilty, D, Yellowlees, P, Nesbitt, T. Evolution of telepsychiatry to rural sites: changes over time in types of referral and in primary care providers knowledge, skills and satisfaction. General Hospital Psychiatry 2006; 28(5): 367–373.

    Article  PubMed  Google Scholar 

  18. D’Souza, RA. A pilot study of an educational services for rural mental health practitioners in South Australia using telemedicine. Journal of Telemedicine and Telecare 2000; 6: 187–189.

    Article  Google Scholar 

  19. Hilty, DM, Cobb, HC, Neufeld, JD, et al. Telepsychiatry reduces geographic physician disparity in rural settings, but is it financially feasible because of reimbursement. Psychiatric Clinics of North America 2008 Mar; 31(1): 85–94.

  20. Larson, JC, Jacob, MK, Craighead, WE. Establishing a telepsychiatry consultation practice in rural Georgia for primary care physicians: A feasibility report. Clinical Pediatrics 2012; doi:10.1177/0009922812441671

  21. Center for Medicaid and Medicare Services (CMA). The Balanced Budget Act of 1997: Pub 100–02 Medicare Benefit Policy. U.S. Department of Health &Human Services (DHHS), 1997. Available online at https://www.cms.gov/demoprojectsevalrpts/downloads/cc_section4016_bba_1997.pdf. Accessed on November 2, 2011.

  22. Center for Medicaid and Medicare Services (CMA). Benefits Improvement Act of 2000. Medicare Carriers Manual, Part 3 - Claims Process Transmittal 1798 U.S. Department of Health &Human Services (DHHS), MAY 16, 2003. Available online at https://www.cms.gov/Transmittals/Downloads/R1798B3.pdf. Accessed November 3, 2011.

  23. Centers for Medicare &Medicaid Services (CMS). The Medicare Patient and Physician Improvement Act of 2008. Pub 100–02 Medicare Benefit Policy Department of Health &Human Services (DHHS), 2008. Available online at https://www.cms.gov/transmittals/downloads/R140BP.pdf. Accessed November 10, 2011.

  24. Participatory Politics Foundation. H.R. 6163 - Medicare Telehealth Enhancement Act of 2008. Available online at http://www.opencongress.org/bill/110-h6163/show

  25. Telemedicine. Medicaid.gov website. Available online at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Telemedicine.html. Accessed July 11, 2012.

  26. Center for Substance Abuse Treatment (CSAT). Considerations for the Provision of E-Therapy. HHS Publication No. (SMA) 09–4450. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2009.

  27. Rose, GL, Skelly, JM, Badger, GJ. Interactive voice response for relapse prevention following cognitive behavioral therapy for alcohol use disorders: A pilot study. Psychological Services May 2012; 9(2): 174–184. doi:10.1037/a0027606

  28. Telemedicine Information Exchange. Available at: http://tie.telemed.org/default.asp. Accessed December 12, 2011.

  29. Smith, HA, Allison, RA. Telemental health: Delivering mental health care at a distance. Unpublished summary report, U.S. Department of Health and Human Services, Office for the Advancement of Telehealth, Rockville, MD, 1998.

  30. Rabinowitz, T, Brennan, DM, Chumbler, NR, et al. Telemedicine and e-Health. Psychiatric Services 2008; 14(9): 972–976. doi:10.1089/tmj.2008.0119.

    Google Scholar 

  31. Kennedy, C, Yellowlees, P. A community based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: preliminary results. Journal of Telemedicine and Telecare 2000; 6 Suppl 1:S155-7.

    Article  PubMed  Google Scholar 

  32. Horowitz, BT. Verizon Previews remote monitoring, telehealth platforms at mhealth summit. eWeek.com 2011Dec. 7.

  33. Miller, W, Baca, C, Compton, W, et al. Addressing Substance Abuse in Health Care Settings. Alcoholism: Clinical and Experimental Research 2006; 30(2): 292–302.

    Article  Google Scholar 

  34. Christopher P, Siemer BS, Fogel, J, et al. Telemental Health and Web-based Applications in Children and Adolescents Child and Adolescent Psychiatric Clinics of North America 2011 Jan; 20(1): 135–153.

  35. James, LC, and Folen, RA. Behavioral Tele-health: Using Tele-medicine to Expand Behavioral Medicine Services. Journal of Healthcare Information Management 1999 Winter; 13(4): 15–23.

    Google Scholar 

  36. Doze S, Simpson J, Hailey D, Jacobs P. Evaluation of a telepsychiatry pilot project. Journal of Telemedicine and Telecare 1999; 5: 38–46.

    Article  PubMed  CAS  Google Scholar 

  37. García-Lizana, F, Muñoz-Mayorga, I. What about telepsychiatry? A systematic review. Primary Care Companion Journal of Clinical Psychiatry 2010; 12(2): e1-e5. doi:10.4088/PCC.09m00831whi

    Google Scholar 

  38. Saeed, A, Diamond, J, Bloch, R. Use of telepsychiatry to improve care for people with mental illness in rural North Carolina. North Carolina Medical Journal 2011; 72(3): 219–222.

    PubMed  Google Scholar 

  39. Krupinski E, Nypaver M, Poropatich R, et al. Telemedicine/telehealth: an international perspective. Clinical applications in telemedicine/telehealth. Telemedicine Journal and E-Health 2002); 8(1): 13–34.

    Article  PubMed  Google Scholar 

  40. Farrell, SP, McKinnon CR. Technology and rural mental health. Archives Psychiatric of Nursing 2003; 17(1): 20–26.

    Article  Google Scholar 

  41. Elford DR, White H, St John K, et al. A prospective satisfaction study and cost analysis of a pilot child telepsychiatry service in Newfoundland. Journal of Telemedicine and Telecare 2001; 7: 73–81.

    Article  PubMed  CAS  Google Scholar 

  42. Ermer DJ. Experience with a rural telepsychiatry clinic for children and adolescents Psychiatric Services 1999 Feb; 50(2): 260–1.

    Google Scholar 

  43. Myers KM, Valentine JM, Melzer SM. Child and adolescent telepsychiatry: utilization and satisfaction. Telemedicine and e-Health 2008 March; 14(2):131–7.

  44. Palmer NB, Myers KM, Vander Stoep A, et al. Attention deficit/hyperactivity disorder and telemental health. Current Psychiatry Reports 2010 Oct; 12(5): 409–17.

  45. Savin D, Garry MT, Zuccaro P, et al. Telepsychiatry for treating rural American Indian youth Journal of American Academy of Child and Adolescent Psychiatry 2006 Apr; 45(4): 484–8.

    Google Scholar 

  46. Greenberg, N, Boydell, KM, Volpe, T. Pediatric telepsychiatry in Ontario: caregiver and service provider perspectives. Journal of Behavioral Health Services 2006; 33: 105–111.

    Article  Google Scholar 

  47. Elford R, White H, Bowering R, et al. A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. Journal of Telemedicine and Telecare 2000; 6: 73–82.

    Article  PubMed  CAS  Google Scholar 

  48. Kopel H, Nunn K, Dossetor D. Evaluating satisfaction with a child and adolescent psychological telemedicine outreach service. Journal of Telemedicine and Telecare 2001; 7: 35–40.

    Article  PubMed  Google Scholar 

  49. Pignateillo, A, Teshima, J, Boydell, KM, et al. Child telepsychiatry in rural and remote primary care. Child Adolescent Psychiatric Clinics of North America 2011; 20(1): 13–38.

    Article  Google Scholar 

  50. Miller TW, Clark J, Veltkamp LJ, et al.: Teleconferencing model for forensic consultation, court testimony, and continuing education. Behavioral Sciences and the Law 2008; 26: 301–313.

    Article  PubMed  Google Scholar 

  51. Gelber, H: The experience in Victoria with telepsychiatry for the child and adolescent mental health service. Journal of Telemedicine and Telecare 2001; 7(Suppl 2): 32–34.

    Article  PubMed  Google Scholar 

  52. Gelber H, Alexander, M: An evaluation of an Australian videoconferencing project for child and adolescent telepsychiatry. Journal of Telemedicine and Telecare 1999, 5(Suppl 1): S21–S23.

    Article  PubMed  Google Scholar 

  53. Myers KM, Valentine JM, Melzer SM. Feasibility, acceptability, and sustainability of telepsychiatry for children and adolescents. Psychiatric Services 2007; 58: 1493–1496.

    Article  PubMed  Google Scholar 

  54. Telehealth in State Substance Use Disorder (SUD) Services. The National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD), 2009. Available online at: http://www.tnpcaeducation.org/resourcelibrary/clinical/Telehealth%20in%20Substance%20Use%20Disorder%20Services%20Report%2009.pdf

  55. King, VL, Stoller, KB, Kidorf, M, et al. Assessing the effectiveness of an internet-based videoconferencing platform for delivering intensified substance abuse counseling. Journal of Substance Abuse Treatment 2009 Apr; 36(3): 331–8.

    Google Scholar 

  56. Rohde, P, Lewinsohn, PM, Seeley, JR. Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. American Journal of Psychiatry 1997; 154: 1593–1598.

    PubMed  CAS  Google Scholar 

  57. Carlson LE, Lounsberry JJ, Maciejewski O, et al. Telehealth-delivered group smoking cessation for rural and urban participants: Feasibility and cessation rates. Addictive Behaviors 2012; 37(1): 108–114.

    Article  PubMed  Google Scholar 

  58. SAMHSA (Substance Abuse and Mental Health Services Administration). From the 2005 Drug and Alcohol Services Information System Report. Available online at http://wwwdasis.samhsa.gov/teds05/TEDSD2k5Chp3.htm. Accessed on May 17, 2011.

  59. Copeland, J, Martin, G. Web‐based interventions for substance use disorders: A qualitative review. Journal of Substance Abuse Treatment 2004; 26(2): 109–116.

    Article  PubMed  Google Scholar 

  60. Washington State Provider Agencies Add Online Element to Services. Alcoholism and Drug Abuse Weekly. Available online at http://www.weinerpublic.com/page131.html. Accessed June 25, 2009.

  61. Frueh, BC, Deitsch, SE, Santos, AB, et al. Procedural and methodological issues in telepsychiatry research and program development. Psychiatric Services 2000; 51: 1522–1527.

    Article  PubMed  CAS  Google Scholar 

  62. Hilty, DM, Marks, SL, Urness, D, et al. Clinical and educational telepsychiatry applications: A review. Canadian Journal of Psychiatry 2004; 49: 12–23.

    Google Scholar 

  63. Porcari, CE, Amdur, RL, Koch, EI, et al. Assessment of post-traumatic stress disorder in veterans by videoconferencing and by face-to-face methods. Journal of Telemedicine and Telecare 2009; 15: 89–94.

    Article  PubMed  Google Scholar 

  64. Morland, LA, Pierce, K, Wong, M. (in press). Telehealth and PSTD psychoeducation groups in the Pacific Islands: A feasibility study. Telehealth and Telecare.

  65. Lange, A, Rietdijk, D, Hudcovicova, M, et al. Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the Internet. Journal of Consulting and Clinical Psychology 2003; 71(5): 901–909.

    Article  PubMed  Google Scholar 

  66. Brooks, E, Manson, S, Bair, B, et al. The diffusion of telehealth in rural American Indian Communities: A retrospective survey of key stakeholders. Telemedicine and E-Health 2012; 18(1): 60–66 doi:10.1089/tmj.2011.0076.

    Article  PubMed  Google Scholar 

  67. Brooks, E, Grinsby, J, Manson, SM, et al. Acceptability of telepsychiatry in American Indians. Telemedicine Journal of E-Health 2008; 14(5): 461–6.

    Article  Google Scholar 

  68. Bair, B, Brooks, E, Dailey, N, et al. Review of American Indian veteran telemental health. Telemedicine Journal of E-Health 2012; 18(2): 87–94.

    Article  Google Scholar 

  69. Yeung A, Hails K, Chang T, et al. A study of the effectiveness of telepsychiatry-based culturally sensitive collaborative treatment of depressed Chinese Americans. BMC Psychiatry 2011; 11: 154.

    Article  PubMed  Google Scholar 

  70. Gibson, K, O’Donnell, SD, Coulson, H, et al. Mental health professionals’ perspectives of telemental health with remote and rural First Nations communities. Journal of Telemedicine and Telecare 2011; (17): 263–267.

    Article  PubMed  Google Scholar 

  71. Wallace PG, Haines A, Harrison R, et al. Design and performance of a multicentre, randomized controlled trial of teleconsulting. Journal of Telemedicine and Telecare 2002; 8(Suppl 2): 94–5.

    Article  PubMed  Google Scholar 

  72. Dongier M, Tempier R, Lalinec-Michaud M, et al. Telepsychiatry: psychiatric consultation through two-way television. A controlled study. Canadian Journal of Psychiatry 1986; 31: 32–4.

    CAS  Google Scholar 

  73. American Tele-medicine Association. Evidence based practice for telemental health. Available online at http://www.americantelemed.org/files/public/standards/EvidenceBasedTelementalHealth_WithCover.pdf Accessed December 5, 2011.

  74. Myers, K, Palmer, N, Geyer, J, Research in Child and Adolescent Telemental Health, Child and Adolescent Clinics of North America Volume 2011; 20(1): 155–171.

    Article  Google Scholar 

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Acknowledgments

This study was made possible with funding from: Life Sciences Discovery Fund Authority, of the State of Washington; OGRD#109212, Roll, J. (PI)

Conflict of Interest

The authors of this work attest to having no conflicts of interest in the subject matter of this manuscript. Further, this work has not been previously published and is not currently being reviewed for publication elsewhere.

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Correspondence to Sandra Benavides-Vaello MPAff, PhD, RN.

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Benavides-Vaello, S., Strode, A. & Sheeran, B.C. Using Technology in the Delivery of Mental Health and Substance Abuse Treatment in Rural Communities: A Review. J Behav Health Serv Res 40, 111–120 (2013). https://doi.org/10.1007/s11414-012-9299-6

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