Applications of telepsychiatry and evaluation of the programme by

the patients Vlantoni, D., Kotsyfi, M., Papastefanou, Y., Toumpa, P.,

Katsadoros, K.

HELLENIC REPUBLIC EUROPEAN COMISSIONMINISTRY OF HEALTH EUROPEAN SOCIAL FUND AND SOCIAL SOLIDARITY

PROJECT CO-FUNDED WITHIN THE FRAMEWORK OF THE O. P. “HEALTH & WELFARE” 2000 – 2006

Telepsychiatry

Telepsychiatry is a composite term for mental health related activities, services and systems, carried out over a distance by means of information and communications technologies for the purposes of mental health promotion, therapeutic interventions as well as education, management and research for mental

health.

Telepsychiatry applications

Video – conferencing Electronic psychiatric file (in cooperation with CCS S.A.)Authorized electronic signature for the issuing of psychiatric reports

Services provided via teleconference

Assessment and diagnosis of casesTherapeutic sessionsPrescription of medication Staff training and other health professionals trainingMedical center doctor support in cases of emergency (e.g. suicide attempt )Staff supervision Prevention campaigns and health promotion seminars for parents and students

Advantages of telepsychiatry

Health services provision on local level Minimization of unnecessary long distance travel for the patientDirect communication with doctors and health staff in remote areas for support, information and ideas exchange, crisis managementModernization of the work environment with the use of state-of-the-art technology – familiarization of the staff with the use of advantaged technology

Covered areas by telepsychiatry

NaxosSantoriniIosAmorgosFolegandrosAnafiThirasiaDonousaSchinousaIrakleiaKoufonisi

For the whole geographical area of the Cyclades there is no psychiatrist either in a public hospital nor in private practice.

We provide services to patients in rural settings with limited access to health care.

Cost of the telepsychiatry method

Telepsychiatry programs can be less expensive for patients, reducing travel time, travel costs and time off from work.

In comparison with the recruitment of a psychiatrist and the cover of the travel expenses around the islands, the cost for a one year period is lower

Cost of the telepsychiatry method

As the system has been installed in the islands medical centers, its combined use with other telemedicine activities could reduce monthly telecommunications costs.

telepsychiatry is a cost-effective method.

Illustration of cases

During the 2 year existence of the mobile unit we have received about 1500 clients. Most frequent diagnosis:

PsychosisDepression disorder Neurosis

Substance dependence (mainly alcohol abuse)

Reasons for visiting the Mental Health Mobile Unit

Psychiatric disorder, counseling, therapeutic sessions: 61%

Attestations for mental health: 20,7%

Accompanying persons with psychiatric disorders without a clear request: 14%

Telepsychiatry evaluation: a pilot study

We delivered a short questionnaire to our clients asking them to evaluate the services provided and to report their level of satisfaction.

AIM:to provide quality mental health services; to improve the telepsychiatry system

Sample description (N=82)

Age: mean 46,3 years (s.d.:15,6)Sex: 42% men, 58% women Education:

primary school: 53high school: 35%, university graduates: 5%

First time in a remote session: Yes, first time: 61%No, many times: 39%

q.1-3 Technical characteristics of the

system

Duration of the session: almost all the respondents reported that the duration

of the session was satisfactory.

Quality of sound and image during the videoconference: about 80% of the respondents appeared to be satisfied with the equipment and setting.

q.4Contact with the psychiatrist

Concerns were expressed by a low percentage (18%) for the impersonal nature of contact in telepsychiatry, while most of the patients (82%) found the contact with their doctor “as not at all cold or impersonal”.

q.6 level of trust towards the

diagnosis and/or the medication

given

Most of the patients (79%) reported that they have no doubt for the diagnosis and the medication given, while only 21% said that they had a slight doubt

q.7level of trust for the protection of privacy

85% of our patients reported that they have no doubt about the protection of their privacy and confidentiality in a telepsychiatric session.

q.8 choice between a face to face session

with a general doctor or a remote

session with a psychiatrist

Two thirds of respondents (63%) were willing to participate in psychiatric treatment delivered via videoconferencing equipment whether a low percentage (18%) would prefer to consult a general doctor in a face-to-face session for a psychological/ psychiatric disorder.

q.9Overall satisfaction of the

patients - I Patients reported to feel rather comfortably during the remote session.

7,55

37,3

56

0

10

20

30

40

50

60

not comfortablyneithercomfortablyvery comfortably

q.9Overall satisfaction of the

patients - IIPatients reported high satisfaction with and acceptance of the use of remote technology for treatment and assessment.

3,7 2,5

38,3

55,6

0

10

20

30

40

50

60

not satisfiedneithersatisfiedvery satisfied

q.9Overall satisfaction of the patients -

III

Rating of the telepsychiatry system by the patients:

39,5

60,5

0

10

20

30

40

50

60

70

almost good

good

Conclusions

Telepsychiatry is an innovative method for the Greek Mental Health System which allows the provision of mental health services in rural and underserved populations.The results of our study provide preliminary support for the telepsychiatry system, but further research has to be made.

References

BROODEY, B., B., et al. (2000) Satisfaction of forensic psychiatric patients

with remote telepsychiatric evaluation, Psychiatric Services, 51, 10.

FRUEH, B., C., et al. (2000) Procedural and methodological issues in

telepsychiatry research and program developing, Psychiatric Services,

51, 12.

MONNIER, J., KNAPP, R., G., FRUEH, B., C., (2003) Recent advances in

telepsychiatry: an updated review, Psychiatric Services, 54, 12.

KENNEDY, Craig (1999) Clinical Practical Guidelines for Using

Videoconferencing Technology in Queensland Mental health Services,

Queensland Telemedicine Network.

ROHLAND, B., M., et al.(2000) Acceptability of telepsychiatry to a rural

population, Psychiatric Services, 51, 5.

WHO (1998), A Health Telematics Policy, Report of the WHO Group

Consultation on Health Telematics 11-16 December, Geneva, 1997

ΚΑΡΑΓΙΑΝΝΗΣ Χ. (2004), εταιρεία ιατρικών οργάνων υψηλής τεχνολογίας και

συστημάτων τηλεϊατρικής, Παρουσίαση των συστημάτων τηλεϊατρικής.

Thank you very much for your presence and for your

attention!

Miss Diamanto Vlantoni,Social Psychologist

diamavlantoni@msn.com