Experts: Telemedicine can bridge mental health gap

Modern technology offers a way to deliver much-needed mental health care to rural sections of Indiana where little or none is available, experts told a legislative study committee Thursday.

Providing psychiatric care through an encrypted computer video link is already helping some providers treat the mentally ill, doctors and officials told the Interim Study Committee on Public Health, Behavioral Health, and Human Services.

That care can include a social worker counseling a patient through a video link in the patient's own home or multi-window, video conference group sessions led by a psychiatrist. Setting up necessary computer and video technology for a caregiver or patient can cost less than $1,000, the experts said. Ordinary video communication software doesn't work because the data must be encrypted to protect patients' privacy, they said.

"Indiana has a real problem with mental health service," said Family and Social Services Secretary John Wernert, a practicing psychiatrist. Eight counties don't have any mental health providers and many other sections of the state are underserved, according to a map Wernert showed the panel,

Joshua Paul, human resources director at Bloomington Meadows Hospital, said the average patient drives 90 minutes to visit a practitioner there. More than 20 percent are referred there by hospital emergency departments, and many are taken there by ambulance, he said.

"One of the biggest reasons for this (telemedicine) is transportation," Paul said.

The experts said telemedicine could improve mental health care in the 23 counties without a psychiatrist. Indiana has 462 psychiatrists, while federal guidelines call for 600, and fewer medical school graduates who go into the specialty are remaining in the state while others retire, they said.

"Those are some alarming numbers," said Rep. Charlie Brown, D-Gary.

By using encrypted video, "we can get health care out to rural areas where these providers just don't exist," said Dr. Jerry Sheward, of Aspire Indiana, a not-for-profit mental health center that serves the Indianapolis area.

There are challenges, however, with reimbursement from Medicaid and insurance companies, and regulations require patients to be in a physician's office or clinic when they connect with a psychologist or psychiatrist, though they can connect with a social worker from the privacy of their own home. Some smaller hospitals that don't offer psychiatric care simply don't have the space or the money in their tight budgets to provide an area for such a connection.

Difficulties aside, Sen. Greg Taylor, D-Indianapolis, was enthusiastic about the telemedicine concept.

"There's a mental health issue in this state," he said. "I believe this is one of the solutions."