Citation

Agley J, Barnes P, Tidd D, Todd A, Friedman K, Gordon S, Richardson J, Delong J. Inquiry (Rochester, NY) 2022; 59: e469580221097428.

Copyright

(Copyright © 2022, Inquiry Journal and Excellus Health Plan)

DOI

10.1177/00469580221097428

PMID

35475403

PMCID

PMC9052818

Abstract

INTRODUCTION: For decades, there has been a deficit of mental health services in rural areas of the United States. Beyond that longstanding need, the COVID-19 pandemic has reportedly increased the prevalence of unmet mental health needs among adults. Presently, many non-critical but urgent mental health concerns are first identified in rural emergency departments. This report describes the results of a 6-month feasibility case study of a program to integrate telepsychiatric triage "upstream" from emergency departments in rural primary care.
METHODS: At routine primary care encounters in a single midwestern rural county, patients at risk for moderate-severe or severe depression, expressing thoughts of self-harm, or otherwise presenting in a way that raised clinical concern for mental or behavioral health, were referred to on-site telepsychiatric triage. Patients whose triage indicated further concern were provided six psychiatric and/or social work encounters for stabilization and treatment.
RESULTS: 68 patients were referred to telepsychiatric triage during the pilot study (.85% of the estimated adult population in the county). Of those, only two had a documented mental/behavioral health diagnosis prior to triage, but 46 were diagnosed with at least one psychiatric disorder during the program.
CONCLUSIONS: This model of telepsychiatric triage was feasible in rural primary care and may support identification and mitigation of unmet mental health needs.

Language: en

Keywords

Humans; United States; Adult; COVID-19; Psychiatry; Pilot Projects; Feasibility Studies; primary care; Primary Health Care; telehealth; case study; Telemedicine; telepsychiatry; rural health; Pandemics