Tele-Psychiatry Reaches Underserved Rural Children and Adolescents Interview with:

Mirna Becevic, PhD, MHA Assistant Research Professor University of Missouri - Department of Dermatology Missouri Telehealth Network

Dr. Mima Becevic

Mirna Becevic, PhD, MHA
Assistant Research Professor
University of Missouri – Department of Dermatology
Missouri Telehealth Network What is the background for this study?

Response: Psychiatry is, by far, the biggest utilizer of telemedicine services on the Missouri Telehealth Network (MTN). MTN supports an average of 4000 tele-psychiatry appointments every month, and 10% of those are provided by the University of Missouri Department of Psychiatry. Since we are all aware of the ever-increasing demand for child and adolescent psychiatry, but also the stigma that goes along with it, we wanted to examine more closely the actual usage of those services at the University of Missouri. What are the main findings?

Response: We found that during the 11-month period of this study, there were 179 unique patients who had 662 tele-psychiatry appointments from 19 different zip codes. The patients were between 13 and 20 years of age, with an average age of 15.9. Not surprisingly, the majority of Missouri physicians are located in urban areas along Interstate 70, and although there are child and adolescent psychiatrists in other areas of the state, many rural counties have none. We also learned that there are a large number of children in Division of Youth Services (DYS) utilizing tele-psychiatry services. This is very encouraging, since we know that most of them would have to be taken in handcuffs and shackles out of the DYS facility to see a provider in person. Telemedicine offers them more privacy and anonymity, as they can stay in their facility and still get the care they need without the additional stressors. What should readers take away from your report?

Response: First and foremost, child and adolescent tele-psychiatry offers valuable services to all patients in need – not only those in rural areas, but also urban and underserved. It also allows patients to see their providers in a timely and efficient manner – without the need for long travel, missing school, or work. Without tele-psychiatry many patients would not be able to see a board-certified child and adolescent psychiatrist due to physical distance or other hardships. What recommendations do you have for future research as a result of this study?

Response: We would want to expand the study to include diagnoses and reasons for visits. Correlating those with in-person visits would allow us to perhaps better understand if the patients are more comfortable seeing providers via video in certain cases, while in others they would still prefer to see their physician in person. Is there anything else you would like to add?

Response: New telemedicine projects, such as Project ECHO (Extension for Community Healthcare Outcomes) go beyond the traditional one-on-one telemedicine. ECHO utilizes telemedicine technologies to mentor and educate primary care physicians to care for patients with specific disease states and conditions. We are getting ready to start a mental health ECHO and are excited to measure the effect and results of such an innovative approach. Thank you for your contribution to the community.


.M. Becevic, T. Green, L. Y. Walker, L. Hicks, E. R. Mutrux.Are There Other Options?: Child and Adolescent Telepsychiatry Services for Rural Population. Journal of Health Management, 2016; DOI:10.1177/0972063416637729

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Last Updated on June 23, 2016 by Marie Benz MD FAAD