Experts in telepsychiatry came together for an event hosted by the University of Arizona College of Medicine on Sept. 10 — World Suicide Prevention Day — to share how telehealth can increase access to mental health services and reduce the stigma around seeking out psychiatric help.
Sara Gibson, MD, psychiatrist and medical director of telemedicine at Blue Cross Blue Shield of Arizona, Health Choice, led the event. While suicide remains one of the leading causes of death in the U.S., Gibson shared one remaining truth: connection saves lives.
For many, that connection isn’t always easy to access. Barriers such as cost, transportation, scheduling and the persistent stigma around mental health can keep people from accessing and maintaining psychiatric help. Telepsychiatry can serve as a bridge to fill that gap.
On the topic of telemedicine, Gibson viewed the resource as more than technology. “Let’s see this as an opportunity to rise, to be curious about what we can do and be creative to revise telemedicine as another means to connect,” Gibson said.
Social connection, Gibson explained, is imperative to one’s physical and mental health. She recognized a study which found that people who lack social connection face health risks comparable to a person who smokes 15 cigarettes a day.
“If someone from an isolated community has to take three buses in the 112 degree weather to see a psychiatrist, that’s not safe and it’s not sustainable for receiving help,” Gibson said.
On college campuses, those barriers often look different. Many students, especially those from out-of-state, live far from their usual care providers and juggle schedules packed with classes, jobs and social commitments.
Leslie Ralph, assistant director of outreach, groups and technology at the UA Counseling and Psychological Services, considered how telehealth options could help students at the UA.
“Many students find that it is easier to fit mental health care into their day when they can use resources remotely,” Ralph said. “Telemedicine also offers a level of comfort and privacy that many students appreciate — there is less face-to-face interaction and potential to run into someone you know in a waiting room, and speaking through a screen can feel more approachable for some people.”
Sophie Singh, co-president of the UA chapter of Active Minds, a student-led club for mental health services, expressed how important suicide prevention is for college students.
“The stigma surrounding mental health remains a significant barrier to people reaching out for support,” Singh said. “Our goal at Active Minds is to destigmatize the conversation surrounding mental health, educate students about the resources available to them and to teach people how to start those difficult conversations. Talking about mental health isn’t harmful, but silence is.”
Singh added that virtual resources are vital in making mental health treatment accessible for everyone. “It allows people who lack transportation, do not have time to commute or present with other barriers to have the opportunity to receive care,” Singh said.
At the end of the day, Gibson’s goal was to encourage connection above all else. She highlighted that while clinical competence from a provider is important, the connection and accessibility of a patient to find help is what can save lives.
“Being able to access care in a way that’s convenient and comfortable is important to anyone’s general mental health, and anything that’s good for mental health can be a part of suicide prevention,” Ralph said. “When it’s easier or more comfortable to access care, we can access that care sooner. Earlier access to care means earlier assessment of risk, identification of risk and intervention.”
Gibson shared that telepsychiatry can increase patient satisfaction and decrease a financial burden — with not having to take time off work or spend money on transportation, child care or emergent hospitalizations for mental health concerns. Telehealth also opens the door for patients to connect with a variety of different psychiatrists until they find someone they align with rather than being bound to physicians in their area.
“Culturally adapted telehealth interventions are essential for maximizing engagement and effectiveness of suicide prevention efforts — the technology itself is less important,” Gibson said.
Gibson mentioned that telepsychiatry is equivalent to in-person methods of psychiatry in terms of assessment, diagnoses, treatment adherence and clinical outcomes. For providers, “telehealth has the same standard of care for seeing a patient in person,” Gibson said.
Gibson did share some ethical risks behind telehealth such as fraud, abuse and diversion. She advised prospective physicians to take caution with audio-only appointments and to ensure identification through confirmation of information like birth dates.
As referenced by Gibson, there is a psychodynamic advantage to telehealth over in-person visits, as it can decrease some social anxiety for the patient or any bad experiences they have had from previous therapies.
Overall, Gibson shared that retention is the most important aspect to seeking out long-term treatment for any mental health issues. Retention, according to Gibson, is more likely to increase with consistent access to virtual resources.
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