Improved access to mental health evaluation for patients with developmental disabilities using telepsychiatry.
The Cedars-Sinai Telepsychiatry Clinic uses a collaborative-care model to treat patients with developmental disabilities. We examined its practice in four areas: patient characteristics, clinical care, symptom severity and diagnostic outcomes to describe the care provided and the population seen in the telepsychiatry clinic. In a chart review, 45 out of 126 cases were selected and evaluated at three times: initial evaluation, year one and year three. Most of the patients (84%) had an intellectual disability, 55% had a pervasive developmental disorder and 71% spoke approximately 50 words or less. Prior to the initial assessment, none of the patients were diagnosed with anxiety or mood disorders, while almost one-third of patients received one of these diagnoses in the telepsychiatry clinic. Patients were seen six times on average in the first year and three times in the second and third years. The telepsychiatrist recommended a change in the patient's medication for 82% of patients at initial assessment, 41% at year one and 46% at year three. The review suggests that telepsychiatry evaluations can be valuable for patients with developmental disabilities, providing diagnostic clarity and specific recommendations that can be implemented by the primary care physician.
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, 8730 Alden Drive, Los Angeles, CA 90048, USA. roxy.szeftel@cshs.org
Roxy
R
Szeftel
Christina
C
Federico
Rashelle
R
Hakak
Zara
Z
Szeftel
Miriam
M
Jacobson
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D002658:Developmental Disabilities / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D011570:Psychiatry / Q000458:organization & administration*; D012189:Retrospective Studies; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult