Abstract
Relevance/Introduction. Rural health-care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health (BH) disorders. Telepsychiatry (TP) and telebehavioral health (TBH) improve access to care and leverage scarce resources. Methods. This chapter focuses on the three areas for rural health care: (1) the intersection of rural health, telebehavioral health, and culture; (2) process improvement, teams, and sustainability; and (3) overview of key clinical and administrative topics. Findings/Results. Telebehavioral health is feasible and empowers rural underserved patients, providers, and systems by helping with everyday practice and teamwork. Both telebehavioral and in-person care require integrated cultural and technology skills. Teamwork, partnerships, and process improvement are instrumental for the rural health mission. Administrative adjustments are needed with technology, in order to optimize workflow and reduce the barriers that detract from providers’ interest and preclude funding/reimbursement. Conclusions. Rural populations need clinical, training, and administrative approaches to integrate telebehavioral health care.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association Cultural Formulation Interview. (2013). Patient version. http://www.dsm5.org/Pages/Feedback-Form.aspx, and Informant Version or http://www.multiculturalmentalhealth.ca/wp-content/uploads/2013/10/2013_DSM5_CFI_InformantVersion.pdf
Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine, 12(6), 573–576. https://doi.org/10.1370/afm.1713
Carlson, J. (2010). Breaking down language barriers. Hospital interpreters get credentialed with new certification programs. Modern Healthcare, 40(46), 32–34.
Cené, C. W., Johnson, B. H., Wells, N., Baker, B., Davis, R., & Turchi, R. (2016). A narrative review of patient and family engagement. Medical Care, 54(7), 697–705.
Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health, 18(1), 174. https://doi.org/10.1186/s12939-019-1082-3
Fisher-Borne, M., Cain, J. M., & Martin, S. L. (2015). From mastery to accountability: Cultural humility as an alternative to cultural competence. Social Work Education, 34(2), 165–181. https://doi.org/10.1080/02615479.2014.977244
Geller, J. M. (1999). Rural primary care providers’ perceptions of their roles in the provision of mental health services: Voices from the plains. Journal of Rural Health, 15(3), 326–334.
Geller, J. M., & Muus, K. J. (2000). The role of rural primary care physicians in the provision of mental health services. Journal of the Washington Academy of Sciences, 86, 131–142.
Gillespie, J., Cosgrave, C., Malatzky, C., & Carden, C. (2022). Sense of place, place attachment, and belonging-in-place in empirical research: A scoping review for rural health workforce research. Health & Place, 74, 102756. Advance online publication. https://doi.org/10.1016/j.healthplace.2022.102756
Hilty, D. M., Ferrer, D., 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.
Hilty, D. M., Crawford, A., Teshima, J., Chan, S., Sunderji, N., Yellowlees, P. M., … Li, S. (2015a). A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implications. International Review of Psychiatry, 27(6), 569–592. https://doi.org/10.3109/09540261.2015.1091292
Hilty, D. M., Lim, R. F., Nasatir-Hilty, S. E., Koike, A. K., Ton, H., & Nesbitt, T. S. (2015b). Planning for telepsychiatric consultation: A needs assessment for cultural and language services at rural sites in California. Journal of Rural Mental Health, 39(3–4), 153–161. https://doi.org/10.1037/rmh0000035
Hilty, D. M., Rabinowitz, T. R., McCarron, R. M., Katzelnick, D. J., Chang, T., & Fortney, J. (2018). Telepsychiatry and e-mental health models leverage stepped, collaborative, and integrated services to primary care. Psychosomatics, 59(3), 227–250.
Hilty, D. M., Gentry, M. T., McKean, A. J., Cowan, K. E., Lim, R. F., & Lu, F. G. (2020a). Telehealth for rural diverse populations: Telebehavioral and cultural competencies, clinical outcomes and administrative approaches. mHealth, 6, 20. https://doi.org/10.21037/mhealth.2019.10.04
Hilty, D. M., Parish, M. B., Chan, S., Torous, J., Xiong, G., & Yellowlees, P. M. (2020b). A comparison of in-person, synchronous and asynchronous telepsychiatry: Skills/competencies, teamwork, and administrative workflow. Journal of Technology in Behavioral Science, 5(3), 273–288. https://doi.org/10.1007/s41347-020-00137-8
Hilty, D. M., Torous, J., Parish, M., Chan, S., Xiong, G., Scher, L., & Yellowlees, P. M. (2020c). A literature review comparing clinicians’ approaches and skills to in-person, synchronous and asynchronous care: Moving toward asynchronous competencies to ensure quality care. Telemedicine Journal and E-Health, 2020. https://doi.org/10.1089/tmj.2020.0054
Hilty, D. M., Crawford, A., Teshima, J., Nasatir-Hilty, S. E., Luo, J., Chisler, L. S. M., Lu, F. G., et al. (2021). Mobile health and cultural competencies as a foundation for telehealth care: Scoping review. Journal of Technology in Behavioral Science, 6, 197–230.
Hilty, D. M., Serhal, E., & Crawford, A. (2022). A telehealth and telepsychiatry economic cost analysis framework: Scoping review. Telemedicine Journal and E-Health, In Press.
Lim, R., Luo, J., Suo, S., & Hales, R. (2008). Diversity initiatives in academic psychiatry: Applying cultural competence. Academic Psychiatry, 32(4), 283–290.
Nelson, C. W. (1985). Does ethnicity matter? Utilization, responses to medical problems, attitudes and satisfaction in a medically underserved community. Journal of Mental Health Administration, 12(1), 34–41.
Office of the Surgeon General Center for Mental Health Services and National Institute of Mental Health. (2001). Mental health: Culture, race, and ethnicity: A supplement to mental health: A report of the surgeon general. http://www.ncbi.nlm.nih.gov/books/NBK44242/
Rosenthal, T. C. (2008). The medical home: growing evidence to support a new approach to primary care. Journal of the American Board of Family Medicine, 21(5), 427–440.
Ross, S., & Allen, N. (2012). Examining the convergent validity of shared mental model measures. Behavioral Research, 44, 1052–1062.
Rost, K., Williams, C., Wherry, J., & Smith, G. R., Jr. (1995). The process and outcomes of care for major depression in rural family practice settings. The Journal of Rural Health, 11(2), 114–121.
Rost, K., Zhang, M., Fortney, J., Smith, J., & Smith, G. R., Jr. (1998). Rural-urban differences in depression treatment and suicidality. Medical Care, 36(7), 1098–1107.
Shore, J. H., & Manson, S. M. (2005). A developmental model for rural telepsychiatry. Psychiatric Services, 56(8), 976–980.
Shore, J. H., Savin, D. M., Novins, D., & Manson, S. M. (2006). Cultural aspects of telepsychiatry. Journal of Telemedicine and Telecare, 12(3), 116–121.
Shore, J. H., Mishkind, M. C., Bernard, J., Doarn, C. R., Bell, I., Jr., Bhatla, R., … Vo, A. (2013). A lexicon of assessment and outcome measures for telemental health. Telemedicine Journal and E-Health, 20(3), 282–292.
United States Department of Agriculture. (2015). What is rural? http://ric.nal.usda.gov/what-is-rural/
Yellowlees, P., Marks, S., Hilty, D., & Shore, J. H. (2008). Using e-Health to enable culturally appropriate mental healthcare in rural areas. Telemedicine Journal and E-Health, 14(5), 486–492. https://doi.org/10.1089/tmj.2007.0070
Yellowlees, P. M., Odor, A., Iosif, A. M., Parish, M. B., Nafiz, N., Patrice, K., … Hilty, D. (2013). Transcultural psychiatry made simple—Asynchronous telepsychiatry as an approach to providing culturally relevant care. Telemedicine Journal and E-Health, 19(4), 1–6.
Yeung, A., Chang, D., Gresham, R. L., Nierenberg, A. A., & Fava, M. (2004). Illness beliefs of depressed Chinese American patients in primary care. The Journal of Nervous and Mental Disease, 192(4), 324–327.
Acknowledgments
-
American Telemedicine Association
-
Telebehavioral Behavioral Health Institute
-
UC Davis School of Medicine and Department of Psychiatry and Behavioral Sciences
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Hilty, D.M., Mishkind, M.C., S. Malik, T., Crawford, A. (2022). Introduction to Rural Telebehavioral Health: Key Clinical and Administrative Issues. In: Hilty, D.M., Mishkind, M.C., Malik, T.S., Crawford, A. (eds) Virtual Mental Health Care for Rural and Underserved Settings. Springer, Cham. https://doi.org/10.1007/978-3-031-11984-2_1
Download citation
DOI: https://doi.org/10.1007/978-3-031-11984-2_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-11983-5
Online ISBN: 978-3-031-11984-2
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)