Archived 14 March 2007
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Introduction
Telepsychiatry is the use of communications technology
(principally video-conferencing) to provide mental health services
from a distance. It is one element of telehealth or, as it is now
becoming known, e-health. Telepsychiatry is effective for case conferencing,
and can be used clinically for both assessment and treatment. The
use of telepsychiatry can enable rural and remote communities to
gain access to psychiatric services, and can also provide support
for health care professionals in rural and remote locations. Professional
support can include case discussions and individual supervision.
From an international perspective, telepsychiatry has been more
established in Australia than anywhere else in the world.
The Victorian Telepsychiatry program was established
in 1996 to improve access to mental health services for rural Victorians.
At that time, 27 video-conferencing facilities were established
at Area Mental Health Services sites in rural base hospitals, mental
health centres and community-based locations across regional Victoria.
Facilities were also established at six specialist service locations.
There are now related telehealth sites in rural and metropolitan
Victoria, including acute or teaching hospitals, community health
centres and several universities.
In 1998, Mental Health Branch commissioned an independent
evaluation of the program. A Telepsychiatry Steering
Committee was subsequently established in late 1999. The role
of the committee includes providing input into the implementation
of the recommendations from the evaluation.
Other
Telepsychiatry Sites
For more information on telepsychiatry and telehealth,
the following sites are recommended:
Evaluation
of the Victorian Telepsychiatry Program - Executive Summary (October
1998)
The Mental Health Branch established the telepsychiatry program
in 1996 to improve access to mental health services for people living
in rural Victoria. Two years after the telepsychiatry program was
implemented, consultants Simsion Bowles and Associates were commissioned
to conduct an independant evaluation of the program. As a result
of the review, the Report on the Evaluation of the Victorian Telepsychiatry
Program was distributed in June 1999. The Executive Summary of this
exaluation is now available on the internet.
Telehealth
Victoria
This organisation aims to develop effective distance health initiatives
and deliver independent practical services for the benefit of the
health industry, government and health consumers. The site includes
a database of telehealth applications in Victoria and booking information.
Sites include Department of Human Services and mental health service
locations.
Royal Australian
and New Zealand College of Psychiatrists
This site includes a position
statement on telepsychiatry and quality practice guidelines.
Australian
New Zealand Telehealth Committee
The role of this committee includes the consideration of issues
arising from the implementation of telehealth and telehealth services
across Australia, and disseminating telehealth information nationally.
The site includes a range of useful information including documents
and reports.
Health
Online
was established by the National Health Information Management Advisory
Council (NHIMAC), and endorsed by Australian Health Ministers in
August 1999. It is not specific to telepsychiatry, but has a range
of information in regard to health online activities.
Centre for
Online Health, University of Queensland
The Centre for Online Health is a research, teaching, education
and service provider within the University of Queensland's Faculty
of Health Sciences. The Centre's mission is: To pursue improvements
in health care through the application of information technology.
John
Mitchell & Associates - Telehealth Links
This site contains an extensive list of links to other telehealth
web sites.
Telepsychiatry
Steering Committee
Terms of Reference
1. To provide input into the implementation of the
recommendations from the Evaluation of the Victorian Telepsychiatry
Program project.
2. To provide a mechanism to facilitate cooperation
and information sharing among participants in the Telepsychiatry
Network with respect to telepsychiatry, telehealth and e-health.
3. Provide input into the development of a formal
policy and management framework to encourage the use of telepsychiatry.
Membership
| Ms Lorna Payne (chair) |
Acting Manager, Service Monitoring and Review, Mental Health
Branch |
| Ms Freida Andrews |
Manager, North East Child & Adolescent Mental Health Service
|
| Dr David Barton |
Psychiatrist/ Co-ordinator, Telepsychiatry, Melbourne Health
Mental Health Program |
| Mr Ken Burnett |
Director of Psychiatric Services, Warrnambool Area Mental
Health Service |
| Prof Graham Burrows |
Director, Clinical Services, Austin & Repatriation Medical
Centre |
| Dr Howard Cooper |
Director, Victorian Child Psychiatry Training Program |
| Mr Harry Gelber |
Senior Clinician, Travencore |
| Mr Ross Izzard |
General Manager, Community Operations, Forensicare |
| Dr John Little |
Director of Clinical Services, Grampians Psychiatric Services |
| Mr David Mithen |
Consumer Consultant, Bendigo Health |
| Dr David Monash |
General Practice Divisions - Victoria |
| Mr Pat O'Leary |
Senior Project Officer, Service Planning & Development, Mental
Health Branch |
| Mr David Proven |
Executive Officer, Mental Health Review Board |
| Assoc Prof. Amgad Tanaghow |
Assoc. Prof/ Director of Clinical Services, St Vincent's Mental
Health Service |
How Telepsychiatry
is used in Victoria
The 1998 evaluation
found that telepsychiatry is used mainly for clinical applications.
From its inception, it was intended that the Telepsychiatry Program
be used for a broad range of applications, including clinical use
for primary and secondary consultation and case-conferencing, and
non-clinical use for supervision, education and statutory review.
Clinical use (primary and secondary consultation,
and case conferencing) accounted for about 70% of reported activity,
the remainder being various non-clinical uses. A range of professions,
including psychiatrists, psychologists, nurses, occupational therapists
and social workers are involved in the use of telepsychiatry, reflecting
the range of professions working in mental health services.
The evaluation found that telepsychiatry has increased
access by rural Area Mental Health Services to specialist services.
The specialist services are Child and Adolescent Mental Health Services;
the Early Psychosis Prevention and Intervention Centre Statewide
Service (EPPIC); and the Mental Health Review Board (MHRB).
The benefits of telepsychiatry were found by the evaluation
to be substantial. These included direct savings in time and travel
costs for service providers, and social benefits to consumers. MHRB,
for instance, was found to accrue $24,500 annually in travel avoidance
benefits, recovering the initial capital investment on a purely
economic basis in just over two years. Less tangible benefits to
consumers and staff are difficult to quantify but still important.
To quote a psychiatric nurse from Ararat:
Nine years ago when I started here I never used
to see a consultant. Then it got better- once a month, and now fortnightly.
But with telepsychiatry during the alternate weeks, it's making
a big difference- for the GPs too.
Telepsychiatry
Seminar - 8 December 2000
On 8 December 2000 seventy mental health clinicians,
managers, psychiatrists, general practitioners, academics, consumers
and carers gathered at the Department of Rural Health in Shepparton
for a productive day of information sharing and discussion. The
focus for the seminar program was the application of video-conferencing
technology within mental health services.
Telepsychiatry which is the use of video-conferencing
in mental health services began in Victoria in 1996. Since then
its use has grown and a range of innovative applications have developed
across the state. This seminar, which was hosted by the Mental Health
Branch, created the first opportunity for mental health services
and others to get together on a statewide basis to discuss the wide
variety of ways people are using this technology.
Deb Podbury, Assistant Director, Mental Health opened
the seminar by video-conference link from Melbourne to Shepparton.
Professor Richard Wootton, Director of Research, Centre for On-Line
Health, University of Queensland also presented a paper on "Telepsychiatry
in the Future" by video-conference. This was followed by presentations
and workshop discussions by a range of mental health service providers
from across Victoria. The seminar also included consumer, carer
and a general practitioners perspective and allowed for discussions
of both current and potential future usage.
The
seminar program is attached. Some of the presentations from the
seminar are available for viewing.
An evaluation of the seminar has been completed. The
formal and informal feedback from the seminar has been consistently
positive. This feedback will be utilised in planning for future
activities. The Mental Health Branch together with the Telepsychiatry
Steering Committee will be undertaking further work in 2001 to progress
the use of telepsychiatry to complement and support the business
activities of both rural and metropolitan mental health services.
Updated March 2001
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