WASHINGTON – The Veterans Health Administration is using information technology to augment care provided by its mental health clinicians to veterans throughout the United States.
Research in VHA has shown that remote treatment of depression by means of telemental health has comparable outcomes to face-to-face care.
According to a 2008 Rand Report, approximately 1.64 million U.S. troops have been deployed in Afghanistan and Iraq since October 2001. The report estimates that 18.5 percent or about 300,000 U.S. service members who have returned currently have post-traumatic stress disorder or depression.
“In individuals with known mental health problems there is no greater population that is more ‘at risk’ than a veteran,” says Diana Rovira, a nurse in Augusta, Ga.
“This is because these individuals are most likely to be ‘lost’ to care and/or follow-up care within the healthcare system,” she says.
Adam Darkins, chief consultant, Care Coordination, U.S. Department of Veterans Affairs, sees telemental health as a way to make mental healthcare services more accessible and convenient for veterans.
“ Telemental health will help veterans to concentrate on integrating back into society without interrupting their lives, especially in rural areas where they have a hard time attracting mental health professionals,” says Darkins.
For veterans in the Hawaiian Islands this rings particularly true, when receiving care could mean hopping a plane.
Leslie A. Morland, a clinical psychologist and health research scientist with the National Center for Post-Traumatic Stress Disorder in Honolulu, Hawaii, a division of the Pacific Islands VA Healthcare System, uses telemental health to connect with veterans on the Hawaiian Islands and conducts research on the quality and clinical effectiveness of these services.
Morland says the convenience telemental health provides isn’t limited to just travel, but also allows veterans to move into the system more quickly so they can be assessed for treatment.
The VA offers three ways to receive telemental health services. Patients can access services from home (more for patients with chronic conditions), a nearby clinic or through the hospital.
Morland says using telemental health does require a little more effort on the part of the clinician. On rare occasions she says there can be technical difficulties and patients have to be prepared with a contingency plan. Clinicians also have to pay more attention to the patient so they don’t miss any non-verbal cues, and they have to establish trust and confidentially early on, she added.
New York-based Tandberg and Pleasanton, Calif. -based Polycom are two examples of IT companies that outfit the VA with video teleconferencing technology or VTC.
John Peters, general telehealth, Care Coordination, VA, says cost wise, “If we are talking about outfitting a clinic and annual maintenance for VTC we are looking at $5, 000 to $7,500 for a pretty basic unit.” A home unit could cost between $1,000, $2,000 and there would be a monthly broadband fee, he says.
