The Adoption of Telehealth in Underserved Populations to Increase Access to Psychiatry Healthcare Essay

The Adoption of Telehealth in Underserved Populations to Increase Access to Psychiatry Healthcare Essay

Accessing psychiatric healthcare can be difficult for underprivileged groups, but telehealth has emerged as a promising approach. This paper examines how telehealth adoption can help expand access to psychiatric care in underserved areas. Telehealth can lower healthcare obstacles like geographical limitations and a lack of access to in-person hospital visits. Achieving equal access to telepsychiatry services will require addressing issues with health equity, digital infrastructure, and data protection. This paper intends to inform healthcare practitioners and policymakers on strategies to improve psychiatric health access in underserved populations by outlining telehealth’s potential advantages and benefits.

Literature Review

Several important conclusions were drawn from research by Xu et al. (2022) that examined telehealth utilization trends during the COVID-19 pandemic in underserved populations. The study aimed to evaluate how telehealth services would affect the availability of psychiatric care in regions with poor access to in-person hospital visits. The study examined three unique periods: pre-pandemic (January 2019 to February 2020), early pandemic (March to June 2020), and late pandemic (July to October 2020). It used Medicaid claims data. Telehealth services increased significantly throughout the pandemic, especially in underserved populations (Xu et al., 2022). Notably, telehealth claims significantly increased in the early and late pandemic eras compared to the pre-pandemic period, increasing 40-fold and 30-fold, respectively. All racial and ethnic groups showed increased telehealth use, with the Hispanic community showing the largest monthly claim growth (Xu et al., 2022). However, the African American group saw a relatively smaller increase in telehealth usage.

Xu et al. (2022) indicated that urban and rural areas adopt telehealth at different rates. Compared to rural areas, metropolitan areas had a higher proportion of telehealth use, with the counties with the highest percentage of telehealth claims coming next to the counties with the lowest percentage. This finding implies that issues, including the lack of high-speed internet and digital devices in remote locations, may have hampered the uptake of telehealth services in certain areas (Xu et al., 2022). Even though telehealth services may improve access to healthcare in underprivileged areas, the study highlighted several issues that need to be resolved. Considerations include providing culturally acceptable telehealth programs for varied populations and enhancing internet infrastructure in remote areas are crucial.

The McCord et al. (2022) study compared the efficacy of in-person and telebehavioral health treatments in rural populations across the United States. More than 1,000 patients participated in the study, which took place at 95 clinical locations throughout 13 states. The study’s primary finding was that telebehavioral health services were as effective as in-person visits in lowering anxious and depressive symptoms among rural underserved patients. In both groups, anxiety and depression symptoms decreased by an average of three points between the pre-intervention and post-intervention assessments one month later (McCord et al., 2022). This finding is significant because it agrees with meta-analyses that examined the efficacy of in-person psychotherapy and telemedicine in direct comparison randomized controlled trials.

Furthermore, McCord et al. (2022) highlighted the advantages of telebehavioral health therapies, particularly in rural areas. According to participants, patients who resided a significant distance from healthcare facilities were most likely to benefit from telebehavioral health services. There was a consensus that telebehavioral health services saved money since they reduced or eliminated the need for travel and needed fewer personnel and facilities. Implications for the future of telebehavioral health service delivery in rural areas are substantial in light of the findings of this study. According to McCord et al.’s (2022) findings, telebehavioral health services can be a good, affordable substitute for in-person care for underserved rural communities. By investing in and enhancing telebehavioral health services, healthcare professionals and policymakers can improve access to mental health care in rural locations (McCord et al., 2022).

According to Bulkes et al. (2021), a comparison was undertaken between the clinical outcomes of patients who got in-person, intensive psychological treatment before the COVID-19 pandemic and those who received telehealth treatment during the pandemic. The main objective was to determine whether telehealth may be a practical substitute for in-person care for people receiving intense therapy. Bulkes et al. (2021) concluded that there were no appreciable differences between the telehealth and in-person groups in the admission scores for quality of life and depressive symptoms. Notably, both groups showed significant improvements in self-reported quality of life and significant decreases in depressive symptoms. To isolate the effect of therapy delivery modality on treatment results independent of these characteristics, the researchers matched the in-person and telehealth groups for pre-treatment covariates, such as age, sex, race, and level of care.

According to observations, patients who received therapy via telehealth at the partial hospitalization level of care had lengthier treatment times (Bulkes et al., 2021). Due to its effectiveness in lowering depression symptoms and enhancing the quality of life, telehealth is a workable care alternative for people requiring intense treatment (Bulkes et al., 2021). The absence of a formal, clinician-administered diagnostic examination upon admission, which would have strengthened the existing diagnoses, limits the findings of Bulkes et al. (2021), which is why. However, the initial diagnostic evaluations were carried out by qualified psychiatrists with substantial expertise in diagnosing mental health illnesses, and patient records were often updated to reflect any adjustments to diagnoses made throughout therapy. This study has important implications for patients and healthcare institutions alike. Telehealth presents a practical alternative for patients who live far from treatment facilities or cannot attend in-person sessions (Bulkes et al., 2021). The huge sample size of the study from a systemic perspective supports telehealth’s efficacy as comparable to in-person therapy for people requiring intense treatment.

Snoswell et al.’s (2021) study combed through meta-analyses on the clinical effectiveness of telehealth services from 2010 to 2019 to conclude its benefits across different medical fields. The analysis found telehealth interventions beneficial to patient outcomes in mental health, psychiatry, chronic illness management, and postoperative care. The authors found that telehealth interventions correlated with lower healthcare costs and more patient satisfaction. They identified several factors that contributed to the success of telehealth therapies. This included integrating telehealth services into existing healthcare systems, mobile health applications for real-time patient monitoring and feedback, and videoconferencing technology to assist remote consultations (Snoswell et al., 2021).

Notably, it was also discovered that patient involvement and education were crucial for promoting the acceptance and efficiency of telehealth services. However, the research revealed certain barriers to the widespread adoption and use of telehealth services. Some of these challenges included privacy and security issues, a lack of healthcare professionals’ confidence in telehealth, and the absence of regulatory frameworks to ensure the reliability of telehealth services. The study highlighted the need for greater research to guarantee telehealth therapy’s longevity and long-term usefulness.

McElroy et al. (2020) looked into how the COVID-19 epidemic caused hospitals to reassess their approaches to patient care. Due to reimbursement constraints, previously ignored telehealth became critical to successfully reimagining safe healthcare delivery in the wake of the pandemic. Removing the crucial obstacle of reimbursement made it easier for people to use telehealth services. The delivery of healthcare has changed significantly as a result of technological developments and legislative efforts, and this has created an opportunity to reduce gaps in access to care, especially for vulnerable groups (McElroy et al., 2020). In this change, telehealth has become a significant role, allowing medical professionals to continue providing care while reducing the chance of contracting a virus.

The McElroy et al. (2020) study brought attention to the possible advantages of telehealth in addressing healthcare disparities. Thanks to telehealth, patients who might have encountered difficulties receiving care can now get the critical care they need. This change had the potential to alleviate inequities and enhance results, particularly for disadvantaged populations. The findings highlighted the need to address discrepancies in telehealth access. The capacity of a patient to utilize telehealth services can be strongly impacted by factors like connectivity, privacy, and digital literacy (McElroy et al., 2020). To eliminate these discrepancies and guarantee equitable access to healthcare for all, immediate and targeted action is needed.

Studies by Lai et al. (2020) looked at the preventive effects of telehealth on dementia patients and the people who care for them during the COVID-19 epidemic. The study concentrated on the advantages of telehealth, specifically videoconferencing platforms, for neurocognitive disorders (NCD) care recipients and their at-home spouse carers. The study involved 62 pairs of care recipients with NCD and their spousal caregivers who were randomly assigned to either a videoconferencing or telephone-only group. The study was conducted in Hong Kong, where social distancing measures were implemented to stop the spread of COVID-19. The telephone-only group received the same health information and assistance via traditional telephone delivery, but the videoconferencing group received additional health information and support using videoconferencing platforms.

Compared to the telephone-only group, the videoconferencing group experienced noticeably superior results (Lai et al., 2020). In the videoconferencing group, caregiver burden, depressive symptoms, anxiety, and quality of life were markedly improved. The videoconferencing group’s care recipients scored higher for their functional abilities, quality of life, and neuropsychiatric symptoms (Lai et al., 2020). The study concludes that telehealth, particularly videoconferencing platforms, can provide additional benefits to care receivers with NCD and their spousal carers, improving results and well-being at home. The study focused on the immediate effects of supplementing video conferences with health information; however, this opened the question of whether the advantages would continue once the extra sessions stopped. Additionally, the research implies that to evaluate the generalizability of the findings, comparative studies between various geographic regions and socioeconomic groups would be useful (Lai et al., 2020). The efficiency and adaptability of telehealth solutions in various settings may be better understood by considering communities that differ in the style and degree of social distance enforcement.

Studies by Chang et al. (2021) address the implications of the post-COVID era’s rapid adoption of telehealth for primary care access and equity. The authors stress the potential benefits of telehealth in infectious disease epidemics, such as less exposure to infectious diseases, enhanced patient convenience, and improved access to care. However, the writers also discuss the difficulties and restrictions of telemedicine, notably concerning health inequalities. They draw attention to the issue that telehealth can worsen already-existing health inequities, especially for underprivileged and marginalized people who might not have access to critical technology or have poor internet connectivity.

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Chang et al. (2021) call for policy measures to ensure more telehealth equity to overcome these potential discrepancies. These adjustments can include better broadband availability, higher financing for telehealth infrastructure, and telehealth service reimbursement procedures. These policy changes are important to ensure that all patients, especially those disadvantaged and underserved, access fair and equitable telehealth services. The digital divide in telehealth is another important topic covered in the. According to Chang et al. (2021), patients in rural or low-income locations may not have access to the required technology or have poor internet connectivity, creating hurdles to the use of telehealth. For all patients to have equitable access to telehealth, it is essential to address the digital gap. Telehealth may not be suitable for all patients or all forms of care, even while it can potentially increase access to care, particularly for individuals in rural or underserved areas (Chang et al., 2021).

Literature Synthesis

Lai et al. (2020), McElroy et al. (2020), and Chang et al. (2021) all established that telehealth has a lot to offer rural communities and primary care during infectious disease epidemics like the COVID-19 pandemic. They strongly emphasize patient convenience, enhanced access to care, and decreased exposure to infectious diseases. In their study of people with dementia and the carers who support them, McElroy et al. (2020) show how telehealth, particularly videoconferencing platforms, improved caregiver burden, sadness, anxiety, and quality of life outcomes. Furthermore, telemedicine can increase access to care, particularly for patients in remote or underserved locations, according to (Chang et al., 2021).

Despite the benefits, writers Bulkes et al. (2021), Lai et al. (2020), and Chang et al. (2021) emphasize the difficulties and restrictions associated with telehealth, particularly regarding health inequalities. They admit that telehealth can potentially widen existing gaps, especially for marginalized and underserved groups who lack access to essential equipment or have poor internet connectivity. According to a study by Lai et al . (2020) on dementia patients and their spouse carers, governmental changes are required to achieve improved telehealth equity, including higher investment in infrastructure and increased broadband availability.

Several authors have emphasized addressing health equality in telehealth, notably Bulkes et al. (2021) and McElroy et al. (2020). They contend that closing the digital gap is necessary to guarantee equal access to telehealth services. Furthermore, Chang et al. (2021) stress the significance of additional studies to ascertain the most efficient applications of telehealth in primary care and its potential influence on health equity. The adoption of telehealth services in underserved communities is the subject of a study by Xu et al. (2022), which highlights the potential advantages of telehealth in eliminating healthcare access inequities.

To guarantee equitable telehealth services, authors Bulkes et al. (2021), Lai et al. (2020), and Chang et al. (2021) call for reforms in policy. They demand better broadband availability, more money for telehealth infrastructure, and better telehealth service reimbursement guidelines. Furthermore, Chang et al. (2021) stress the significance of tackling the digital divide and providing essential resources to guarantee universal patient access to telehealth.

Literature Analysis

The findings from the literature review give significant insights that can help improve the number of patients in underserved populations obtaining psychiatry care through the implementation of telehealth. To remove obstacles and improve marginalized areas’ access to mental health services, the literature study delivers significant results and policy recommendations. Access to physical healthcare facilities is a major barrier for marginalized individuals seeking psychiatric treatment, particularly in rural locations. According to Xu et al. (2022) and McElroy et al. (2020), telehealth can close this gap by offering remote consultations and lowering travel requirements. Patients can get psychiatric care using telehealth platforms like video conferencing, which increases convenience and lowers barriers linked to commuting. People in underprivileged communities who have trouble getting to healthcare facilities because of distance restrictions or a lack of transportation options may find this helpful.

The research by Xu et al. (2022) and McElroy et al. (2020) highlight how critical it is to resolve inequalities in access to telehealth services. To ensure fair access to telehealth, Bulkes et al. (2021) supported policies focused on increasing broadband access and enhancing digital infrastructure. Underserved communities can acquire equal access to telepsychiatry services by concentrating on bridging the digital divide, hence lowering inequities in mental health care.

According to Chang et al. (2021), telehealth also can address issues with infectious disease epidemics. Telehealth can maintain the continuity of psychiatry healthcare during public health crises like the COVID-19 pandemic while lowering the risk of infection. Healthcare systems can better prepare for upcoming emergencies and guarantee service continuity for marginalized populations by promoting the implementation of telepsychiatry.

The research by Lai et al. (2020) and McElroy et al. (2020) proves that telehealth, particularly videoconferencing platforms, can enhance the mental health of dementia care recipients and their caregivers. These results imply that telepsychiatry interventions can go beyond conventional mental health services and address particular needs in underprivileged communities. Telehealth can offer additional health information and support to caregivers in underserved areas, lowering caregiver load and enhancing overall mental health outcomes.

Policy improvements are essential to increase the number of patients in underserved populations that receive telehealth for psychiatry services. The authors stress the necessity of enhanced reimbursement regulations, more financing for telehealth infrastructure, and increased broadband availability. The authors also support a greater investigation into the value of telehealth in primary care and its effects on health equity. Healthcare practitioners and governments can decide how best to give telehealth services to underserved communities by undertaking thorough research to evaluate the specific advantages and difficulties of telepsychiatry therapies in these populations.

Conclusion

Telehealth offers a game-changing opportunity to expand access to psychiatric care for marginalized groups. The literature review has shown that telehealth services significantly increased usage during the COVID-19 epidemic, particularly in underserved populations, bridging the gap in psychiatry and mental health care. Studies have shown that telehealth, especially in remote locations, can bring convenience and save healthcare costs while giving equivalent effectiveness to in-person care. The findings further emphasize the significance of tackling health equality and digital disparities to ensure the widespread and fair use of telehealth. To remove obstacles preventing marginalized groups from using telehealth services, policymakers must prioritize programs to increase broadband access, enhance digital infrastructure, and implement suitable reimbursement rules. More analysis and study are required to determine the long-term effect of telemedicine on mental health outcomes in underprivileged regions. Healthcare professionals and policymakers can improve the potential of telehealth to expand psychiatric health access and boost general mental health outcomes in marginalized communities by adopting evidence-based practices and regulatory improvements.

References

Bulkes, N. Z., Davis, K., Kay, B., & Riemann, B. C. (2021). Comparing efficacy of telehealth to in-person mental health care in intensive-treatment-seeking adults. Journal of Psychiatric Research, 145. https://doi.org/10.1016/j.jpsychires.2021.11.003

Chang, J. E., Lai, A. Y., Gupta, A., Nguyen, A. M., Berry, C. A., & Shelley, D. R. (2021). Rapid transition to telehealth and the digital divide: Implications for primary care access and equity in a post‐COVID era. The Milbank Quarterly, 99(2), 340–368. https://doi.org/10.1111/1468-0009.12509

Lai, F. H., Yan, E. W., Yu, K. K., Tsui, W.-S., Chan, D. T., & Yee, B. K. (2020). The protective impact of telemedicine on persons with dementia and their caregivers during the COVID-19 pandemic. The American Journal of Geriatric Psychiatry, 28(11), 1175–1184. https://doi.org/10.1016/j.jagp.2020.07.019

McCord, C., Ullrich, F., Merchant, K. A. S., Bhagianadh, D., Carter, K. D., Nelson, E., Marcin, J. P., Law, K. B., Neufeld, J., Giovanetti, A., & Ward, M. M. (2022). Comparison of in-person vs. telebehavioral health outcomes from rural populations across America. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-04421-0

McElroy, J. A., Day, T. M., & Becevic, M. (2020). The influence of telehealth for better health across communities. Preventing Chronic Disease, 17(64). https://doi.org/10.5888/pcd17.200254

Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J., & Smith, A. C. (2021). The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019. Journal of Telemedicine and Telecare, 0(0), 1357633X2110229. https://doi.org/10.1177/1357633×211022907

Xu, P., Hudnall, M., Zhao, S., Raja, U., Parton, J., & Lewis, D. (2022). Pandemic-triggered adoption of telehealth in underserved communities: Descriptive study of pre- and post-shutdown trends. Journal of Medical Internet Research, 24(7), e38602. https://doi.org/10.2196/38602

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Literature Synthesis and Analysis (Assignment G, 100 points)
Attached is also an evidence review sheet and annotated bibliography.
For this Assignment, the student will analyze and synthesize the evidence on the worksheets and write a literature review.
Assignment Steps To complete the assignment, the student will:
1. Use the information in the Evidence Review Worksheets, including the annotated bibliography tables, to coalesce a coherent representation of the evidence and how it applies to and informs decisions you made for your final scholarly project.
Please let your writing have sub-headings according to what you are writing. Let your writing be directly related to the assignment and project topic especially the project topic, picot question and intervention which is the use of telehealth compared to in-person hospital visit to solve the problem of limited access to psychiatric health services in underserved communities.
Examples of sub-headings are as follows:
A. Introduction
B. Literature Review
C. Literature analysis
D. Literature Synthesis

PICOT Question
In underserved communities facing limited access to psychiatry health services (P), does the use of telehealth (I), compared to in-person hospital visits(C), affect the number of patients accessing psychiatry health services (O) within 3 months (T).