“The study started at a time where clinicians had reservations about treating psychiatrically complex patients with telehealth or integrated care models,” said researcher Dr. Jennifer Severe.
“Understandably, engagement in care was one of the many concerns. This study showed that patients with multiple psychiatric conditions and who also struggle with several chronic physical health problems can engage well in mental health treatment with their primary care doctors or remote mental health specialists.”
Teletherapy continues to be useful for consumers
For the study, the researchers analyzed data from over 1,000 participants enrolled in the Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT). The participants were struggling with bipolar disorder, post-traumatic stress disorder (PTSD), or both.
The team put two virtual therapy options to the test: telepsychiatry collaborative care and telepsychiatry enhanced referral. The first method involves collaboration from both virtual and in-person health care professionals; a virtual therapist provides a diagnosis, and then an in-person physician and clinic team works with the patient and the virtual therapist to provide medication and in-person counseling. Enhanced referral requires a psychiatrist to prescribe medication and handle the diagnosis in-person, and then the patient will receive virtual counseling.
Ultimately, the researchers learned that both forms of teletherapy were effective for the participants. The combination of medication and talk therapy proved to be beneficial for patients with PTSD, regardless of the severity of the symptoms, and bipolar disorder.
The researchers found that participants who were able to connect in-person with a local mental health professional were more diligent about attending their therapy appointments. Compared to those who had primarily video sessions, those who went to in-person therapy sessions went to 60% more of their scheduled sessions.
The study also looked at specific factors that could impact the participants’ willingness to engage in therapy or follow through with medical treatment plans. Participants with higher levels of mania were less likely to begin therapy, regardless of which telehealth program they were involved in. Conversely, participants struggling with other physical health conditions were more likely to be consistent with their mental health treatments.
“Both tele-integrated and tele-referral care offer an opportunity to treat patients with complex psychiatric conditions,” the researchers wrote. “While there was no difference in clinical characteristics predicting engagement, onsite care managers engaged patients in more psychotherapy sessions than remote therapists.”