Outcomes of Telepsychiatry in Australia, a clinical review

Helen Devery and Peter Sheeran

Introduction

Use of telephone and videoconferencing technologies by psychiatrists is a frequently proposed solution to address lack of resourcing and staff shortages in regional and rural areas. The Royal College of Australian and New Zealand Psychiatrists endorses the use of telepsychiatry as a means of increasing access to services. Despite this, there is a lack of available evidence about the outcomes and effectiveness of telepsychiatry compared to conventional face-to-face interventions provided by psychiatrists within Australia.

Objectives

This scoping review aimed to identify studies reporting the implementation of telehealth psychiatry within Australia with an aim to evaluate the outcome of these interventions.

Methods

Database searches of EBSCO, Medline, Pubmed and Google Scholar for the keywords: (telepsychiatry) AND (outcomes or benefits or effects or impact or effectiveness) AND (in Australia or Australia or Australian). Additional filters of ‘full text’, ‘peer reviewed’ were applied. Only sources reporting telepsychiatry by psychiatrists within Australia were included. Telemental health services provided by other health professionals were excluded.

Results

1050 articles were identified during initial searches. Duplicates were removed and titles and abstracts were screened for inclusion. The full text of 65 articles was reviewed resulting in 29 studies identified as suitable for inclusion in the current review.  

We identified several limitations with the current available research including small sample sizes, few experimental designs and limited information on clinical outcomes using validated measures. Despite these limitations we identified several positive and some negative key themes. Positives included increased service capacity, and willingness of professionals to utilise telepsychiatry services when these were made available. Negatives included inequitable distribution, and the ability of patients with chronic conditions such as schizophrenia to engage with telepsychiatry.

Conclusion

Telepsychiatry can increase the availability of expert mental health care, however, inequality in distribution and ability of patients to engage with this medium may limit its effectiveness. Further methodologically rigorous reviews are required.