America / Healthcare / Technology

Tele-Psychiatry Included in Mental Health Reform Bill

The day after a gunman stormed Fort Hood and the media reported the assumed presence of mental illness, the Subcommittee on Health held a hearing on the Helping Families in Mental Health Crisis Act of 2013, H.R. 3717. The Act aims to redistribute funding in mental health programs and to improve mental health services by creating an Assistant Secretary for Mental Health at the Department of Health and Human Services, changing privacy regulations to allow caregivers access to additional information during a time of potential harm, ensuring access to the best medications and treatment and providing funds for additional training to law enforcement and college counselors.

One of the most significant components of the legislation is the establishment of tele-psychiatry grants, which would be used by specially trained physicians to diagnose, mitigate and treat mental health disorders using tele health technology. By using this technology, patients can gain access to a physician anywhere the technology goes; at work, in a car, at a restaurant, or even from bed.

The development and expanded use of this technology could be critically important especially for those who suffer from severe mental illness. According to the National Institute for Mental Health one in four Americans age 18+ suffer from a mental illness including mood disorders, schizophrenia, anxiety disorders, among others. The main “burden of illness” resides within the six percent of the population diagnosed with severe mental illness.

According to the National Institute of Health, individuals with severe mental illness are twice as likely to develop a substance use disorder. Among those with both a mental illness and substance use disorder, approximately eight percent receive adequate treatment while more than 53 percent receive no treatment at all. Telemedicine technologies have the potential to overcome obstacles for this population such as the inability to leave one’s house, to find adequate transportation or to find a proper specialist in the immediate area.

Another aspect of mental illness that may be impacted by telemedicine is the pervasive occurrence of non-adherence. Non-adherence to prescribed medications is a serious problem among individuals with mental illness. According to the Treatment Advocacy Center, 55 percent of individuals stopped taking medications due to anosognosia, the belief that they are no longer sick or require medication treatment. This occurs among individuals with schizophrenia and bipolar disorder most often — as patients believe they are healthy due to the natural upswings or episodes of mania they experience as part of their disorder. Individuals who become noncompliant with their medications often experience a relapse of symptoms, homelessness, exhibit acts of violence or require more costly care in the form of re-hospitalization or jail. It would be most beneficial to support research on maximizing the capabilities of telemedicine to help those most in need.

Although shootings such as the most recent at Fort Hood are typically the actions of individuals with mental illness it is important to remember not all people with mental illness are violent. These events do bring attention to the desperate need for the development of an emergency mental health resource. Perhaps telemedicine can be part of the answer to society’s most desperate question on how to end the violence.