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  • Tell It To a Telepsychiatrist: Online Counseling and Psychiatry

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    Tell It To a Telepsychiatrist: Online Counseling and Psychiatry

    Sometimes it can be hard for those suffering from mental illness to seek help, as a result of social stigma, lack of access to care and lack of funds. Through recent advancements in technology, though, it’s becoming possible for patients to get help more easily and cost effectively: With the Internet, the doctor is (always) in.

    Mental Illness in the U.S.

    Mental illness is prevalent in the United States, and it’s not always easy to find care – but since Internet access is widespread, online therapy and telepsychiatry can help change that.

    43.7 million

    Number of adults 18 or older in the U.S. with any mental illness in 2012 (1)

    9.6 million

    Number of adults 18 or older in the U.S. with a serious mental illness in 2012 (1)

    55%

    Percentage of U.S. counties with no practicing psychiatrists, psychologists or social workers (2)

    74.8%

    Percentage of U.S. households with Internet access (3)

    What Is Telepsychiatry and Online Therapy?

    Telepsychiatry is a form of Internet video conferencing that offers psychiatric services to those in remote locations or otherwise underserved areas, as well as those who for other reasons cannot or prefer not to see a psychiatrist in person. (4)

    Likewise, online therapy – also called e-therapy, e-counseling, tele-therapy or cyber-counseling – allows therapists or counselors to give psychological support and advice through the Web through email, video conferencing, chat or Internet phone. (5)

    Who Does What?

    Whether treating patients online or in person, psychiatrists, psychologists, counselors and social workers have related but different roles in the mental health field. (6-7)

    Title: Psychiatrist

    Job description: A medical doctor who diagnoses and treats mental illness

    Licensed for: Writing prescriptions for medication, providing psychotherapy (though not all offer therapy)

    Schooling: Four years of medical school culminating in a medical degree (M.D.); a one-year internship; at least three years of specialized training

    Title: Psychologist

    Job description: A mental health professional who evaluates and treats mental illness

    Licensed for: Providing psychotherapy, offering counseling, conducting psychological testing

    Schooling: Doctoral degree (Ph.D., Psy.D., Ed.D.) in psychology; two- to three-year internship

    Title: Licensed Mental Health Counselor

    Job description: A mental health professional who evaluates and treats mental illness

    Licensed for: Providing psychotherapy, offering counseling

    Schooling: Master’s degree (M.A.) in psychology, counseling or related field; at least two years of supervised postgraduate experience

    Title: Clinical Social Worker

    Job description: A mental health professional who evaluates and treats mental illness

    Licensed for: Providing psychotherapy, offering counseling, offering case management, helping with discharge planning, advocating for patients and their families

    Schooling: Master’s degree in social work (M.S.W.); at least two years of supervised postgraduate experience

    Finding Care

    Telepsychiatrists can partner with hospitals and mental health clinics, expanding the institutions’ outreach to patients, or they can contract with a web-based company that provides a directory of providers that patients can contact directly, like www.telepsychiatry.com or www.e-psychiatry.com. (8-10)

    Online therapists generally contract with web-based companies that allow patients to contact the provider directly.

    Breakthrough.com offers online video psychotherapy with a range of licensed counselors, social workers, psychologists and psychiatrists. Sessions range from 15 minutes to one hour. Certain major insurance providers cover Breakthrough, and providers also offer self-pay rates. (11)

    423

    Number of patients treated via Breakthrough in a 12-month period (11)

    Talkspace.com offers online video therapy with licensed therapists for $29 per half hour. The site also offers “messaging therapy,” where clients may text a therapist on an unlimited basis for $25 a week, whenever the mood strikes them, and once or twice a day the therapist will respond. (12-13)

    50,000

    Number of Talkspace users (14)

    7Cups.com pairs users with active listeners, either through their peers – meaning other users just like them who are trained to listen – for free, or with licensed therapists, for a per-minute fee.

    Clients can narrow down who to talk to by topic of conversation, or just by who’s available that very instant. (15-16)

    More than 5,000

    Number of 7CupsofTea users helped in one week (17)

    Benefits of Online Therapy and Telepsychiatry (18)

    • Ease of access, especially for those living in underserved areas
    • 24/7 availability, or close to it, depending on the site or provider
    • Lack of stigma
    • Those suffering from certain types of disorders may find it easier to talk to a therapist or psychiatrist over the Internet instead of in person

    $1,400

    Estimated money saved per episode of telepsychiatric care (8)

    200%

    Estimated improvement in certain patients’ mental health as a result of being more likely to seek follow-up care (8)

    Drawbacks (18-19)

    • Providers can generally only treat patients living in the state they’re licensed in
    • Potential for Internet connectivity problems
    • Providers generally can’t provide crisis counseling or emergency services
    • Not right for everyone – some people prefer or need an in-person connection

    Insurance Coverage

    43 states plus the District of Columbia offer some form of Medicaid reimbursement for telehealth services, including telepsychiatry. (20)

    telepsychiatry

    Sources:
    1. http://www.nimh.nih.gov
    2. http://www.aha.org
    3. http://www.census.gov
    4. http://www.psychiatry.org
    5. http://psychology.about.com
    6. http://www.webmd.com
    7. http://www.amhca.org
    8. http://www.informationweek.com
    9. http://www.telepsychiatry.com
    10. http://www.e-psychiatry.com
    11. http://www.breakthrough.com
    12. http://www.talkspace.com
    13. http://thenextweb.com
    14. http://blogs.wsj.com
    15. http://www.7cups.com
    16. https://wefunder.com
    17. http://www.fastcolabs.com
    18. http://foxct.com
    19. http://www.ncsl.org