Telepsychiatry—The Future of Transforming Mental Health is NOW

Telepsychiatry—The Future of Transforming Mental Health is NOW

For the last six years, I have become increasingly interested and excited about a future where mental health treatment utilizing internet technology becomes state of the art.  We are quickly approaching that day.  

Telepsychiatry is the art and science of providing mental health services to individuals and groups using advanced forms of video-conferencing to connect people who otherwise would not be likely to meet.  Despite what some might think upon a first glance, there are countless advantages to psychiatry being done this way and minimal disadvantages. In fact, as a psychiatrist, I have now reached the point where my preference is to meet a patient online rather than in an office, due to the massive available positive impact that I have found this modality to offer.  

Over the years, I have participated, directed, and managed many forms of patient care in several different capacities and settings.  I now find this new remote psychiatric work extraordinary on many levels. The patient’s results are frequently spectacular and efficient, with surprising life-changing outcomes often reported in the first session or two.   This rate of success far exceeds that which could be expected using conventional techniques established and maintained over the past 3 or 4 decades.

An abbreviated list of advantages that I am encountering using Telepsychiatry tools:

1)  I can work from home, and the inherent ease and comfort of doing so allows me to be present like I have never been before for therapeutic interactions.  

2)  Nuances and quirks are more noticeable on line, and the art of getting someone’s world is enhanced considerably using the video-conference interface.  People tend to be less inhibited and less focused on all the things we are unconsciously concerned with when we are actually with another person. The patients often get a more genuine me, and I get a more authentic them with an accompanying natural ease, grace, and resonance.  

3)  Boundary issues, although not a significant concern in most psychiatric contacts are eliminated in the virtual world.   Since hands-on is not a real option, this boundary is maintained at all times and creates an increased sense of safety for each party so that the conversations proceed smoothly and flawlessly.  

4)  By being so naturally close to the camera, the patients are actually “closer” to me than could ever be appropriate in an office setting, and there is not a violation of space to be concerned about as this occurs.  Subtle non-verbal interactions are therefore picked up in both directions, and with experience and training, the clinician’s observations and relatedness increases several-fold, offering an inside track on what treatments or interventions might be best utilized for each specific case.   

5)  I can meet with patients from wherever I am, within reason.  As long as there is a good enough connection (and this is the case now in an ever-increasing number of areas worldwide) I can see a patient from anywhere, including internationally or from a hotel room or friend/family member’s home, without burdening them to do anything differently to accommodate my altering circumstances.  

6)  It is now reasonable to work with one or a couple of patients at a time, given that there is no extra time necessary to allow for travel, parking, setting up office, and returning home afterward.  

7) When there is a no-show, I can immediately complete personal work in the home, on the telephone, or even outdoors in my familiar environment without much trouble, something that certainly is not easy when patients are seen in a conventional setting away from home.  I can also review the chart extensively if I want to, given the prevalence of electronic medical records, that is concomitantly growing in the medical field as a whole. 

8)  My web presence is who I am in this setting.  With some minimal coaching, this presentation heads toward impeccability quickly and is much easier to maintain than managing all of the aspects of what a face-to-face meeting entails.  Clothing choices are also expanded, given that I am generally only seen from the neck up for the session.  

These are just a few examples of how virtual psychiatry is offering a more comfortable, more fun, more effective way of providing mental health maintenance services for the entire industry.  The future of this field is now completely open, and what will be created is yet to be seen. With a vision and intention, and the injection of a created future, the field of mental health is getting a facelift, one that in my opinion, is drastically overdue and, therefore, completely welcome.

Fred R. Moss, MD