title: A retrospective evaluation of TeleMental Healthcare services for remote military populations.
abstract: The objective of this study was to compare specific treatment and outcome variables between mental health care via videoconferencing to care provided in person. The study was a retrospective record review of service members and their adult civilian family members seen at two remotely located military bases. One group was seen via video conferencing (telemental health care [TMHC]) while a second group was seen face-to-face care (FTFC) and served as a control group. Chi-square tests were used to test for significance associations between therapy format and secondary variables. The Global Assessment of Functioning was unexpectedly and significantly more improved for the TMHC group than the FTFC care group. Mean change in Global Assessment of Functioning for FTFC (8.4) was significantly less than mean change for TMHC (15.3). There were no significant differences between the groups in the number of laboratories or studies ordered, self-help recommendations made, selected mental status elements, or number of patients prescribed two or more psychotropic medications. The rate of full compliance with the medication plan and follow-up appointments was significantly better for TMHC. Providers using TMHC told more patients to return for follow-up appointments in 30 days or less. Improved compliance, the unique interpersonal processes of care via TMH, and slightly shorter times to next follow-up appointment were the chief contributors. Alterations in the process of communication may have implications in the business, political, and military sectors.
authors.affiliation: Sheppard Pratt Health System, TeleBehavioral Services, Baltimore, Maryland, USA. grady@telepsychiatrist.com
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Grady
authors.forename: Ted
authors.initials: T
authors.lastname: Melcer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards* / Q000639:trends; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D008890:Military Psychiatry / Q000592:standards* / Q000639:trends; D011336:Probability; D012016:Reference Values; D019114:Remote Consultation / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D019035:Rural Health Services; D012680:Sensitivity and Specificity