The future has arrived. Let's say you deal with an absolutely jam-packed schedule that makes regular psych appointments basically laughable, or you live in a place where there just aren't a ton of specialists, or hell, both—access to mental health care can be tricky. But thanks to the internet, telepsychiatry and teletherapy can eliminate these barriers, helping many people receive care they'd have a hard time accessing otherwise.
While telemedicine generally is becoming more and more common, mental health is at the forefront for a simple reason. "Psychiatry is uniquely suited for telemedicine services since psychiatrists don't typically perform physical exams," says Sandip Buch, M.D., founder of Skypiatrist.com.
Rural Americans can especially benefit.
America is a big place. We're not the most heavily populated nation in the world, but we are one of the most geographically dispersed. This has meant that many Americans living in rural areas have limited access to health care in general, with psychiatric care often being especially hard to come by.
But telepsychiatry has the power to provide quality mental health care to areas that don't have psychiatrists nearby. "As a child psychiatrist who works with telemedicine, you really get to become an integral part of the community you serve," says Tarik Shaheen, M.D., founder of Iris Telehealth. "You get to know the teachers, the families, the culture—you become the town's doctor in a way that feels more intimate than practicing in a bigger city."
Stephanie Hall, M.D., is also a child psychiatrist and one of the telepsychiatry doctors at Iris Telehealth. She feels that children and adolescents take to this kind of therapy particularly well. "I usually tell my new patients that it's like FaceTime on steroids," Hall says.
"As long as I'm excited for whatever progress they're making, they seem to relate pretty well. I'm waving my hands in the air about great grades and wiggling in my seat with joy if they're feeling better... but I would do that in person too. I have real relationships with these kids! And it's fun."
Hall feels that the best part of telepsychiatry is the satisfaction of knowing that kids who wouldn't normally be getting psychiatric care are gaining access, especially where she works, in Mississippi. "I see parents and grandparents who are struggling to provide resources for their kids. It's delightful to know that I'm helping in that situation in a significant way," she says. "Telepsychiatry goes a long way toward spreading expertise around to those in the most need. Talk about satisfaction!"
New moms can also benefit (and so can people with anxiety and depression).
Telemedicine is great for a wide range of people who might otherwise have trouble showing up for an in-person appointment—which means it can be a lifesaver for women who have recently given birth. "Postpartum depression is an important condition to evaluate and treat," Buch says. "But getting to a clinic with a newborn is a big hassle—and one that's eliminated when you can see your doctor from your home."
As you know if you've been there, normally simple tasks—like, say, taking a shower and most definitely driving to an appointment—can become absolutely Herculean efforts when you're dealing with issues like depression or anxiety. This means access to care can be the most difficult at exactly the time patients need it the most.
For patients who can't physically get to a psychiatrist on their own, the barrier can be even higher—especially for people who rely on caretakers to drive them to an appointment. "With telemedicine, being able to simply put the patient in front of a screen makes it significantly easier for all involved," Buch says.
So will a teletherapy appointment set you back more than a regular appointment?
Of course, in America, basically every conversation about health care circles back to the same question: "How much is this going to run me?"
While a telepsychiatry appointment won't make for a cheaper copay, it can save on transportation costs, and patients don't have to take time away from work to see their doctor. However, some insurance plans don't cover telemedicine practices, so check to make sure yours is on the good-to-go list before scheduling an appointment.
What's it really like as a patient?
Katie Davis, Psy.D., a Manhattan-based clinical psychologist, tried the practice out for herself. "I liked that teletherapy wasn't cost-prohibitive and that it was easy to fit into my schedule," she says. "I participated in teletherapy as I was trying to get my own private practice off the ground, which was very time-consuming and made my schedule somewhat unpredictable. So being able to text whenever I had a free moment was helpful.
"I also found teletherapy helpful in the same way that I've found journaling helpful—in the moment, it was cathartic to write it all down, and later, it was interesting to go back and read the ways in which I described various stressors."
Although the system varies from service to service (and so do the options—a therapist is much more likely to provide that texting option than a psychiatrist), appointments are usually scheduled the same way: directly through the provider's website. For telepsychiatry, the first appointment is typically 45 minutes to an hour, and follow-ups are often 10-15 minutes.
And while you don't have to have a psychiatrist who lives in your state, they do need to be licensed in the state where you live. Many psychiatrists with telepsychiatry practices are licensed in several states, so if you check with your insurance, you can find someone who's a fit for you.
And if you're worried about your personal conversations with your shrink getting out, that's been thought of too—the video chat systems both psychologists and psychiatrists use have to meet security requirements that are extremely stringent—this isn't the same as talking with someone on Facebook chat or Skype. "There are guidelines that the government sets in terms of privacy for video chat to ensure that it's secure and meets HIPAA guidelines," Buch says.
And the best part: Yes, psychiatrists who work remotely can send your prescription to your local pharmacy—even if it's several time zones away.