Telepsychiatry: A growing option for discreet, quality mental health care

Jeffrey T Junig MD PhD is responding to a growing demand for ‘old-fashioned’ psychiatric services across the country and even internationally, using the new technology of telepsychiatry. End Quote

Telepsychiatry allows a level of privacy, comfort, and convenience not available from 'systems-based' psychiatry practices.

Appleton, WI (1888PressRelease) October 12, 2009 - Receiving treatment for anxiety or depression carries a stigma in our society despite educational efforts by mental health organizations. At the same time, medical practices including psychiatry have become centralized into health ‘systems.’ This centralization provides convenience for patients visiting both their family physician and one or a combination of specialists. But the combination of multiple specialties in one location has significant drawbacks for patients who desire some degree of privacy. In many areas, going to the psychiatrist means registering at the same clinic window that is used by people visiting other types of physicians, and/or sitting in waiting areas shared by neighbors visiting the obstetrician or family practice physician. Patients are forced to deal with the question, ‘what are you hear for?’ They then wonder how long it will take for everyone in their small town to hear about their trip to the shrink!

Meanwhile, psychiatric visits in many regions have been reduced to 10-minute sessions, providing insufficient time for proper care. Psychiatrists talk about ‘door-knob confessions’, the comments made by patients in the closing moments of a session. Time is required for patients to feel safe enough to talk about embarrassing symptoms or shameful behaviors. In the modern, rushed ‘med check’, patients barely have time to describe the most pressing side effect to medication—let alone talk about problems in their marriages or fantasies of running away to start a new life.

Jeffrey T Junig MD PhD of www.telephonepsychiatry.com talked with us about some of the problems with modern psychiatry. “We used to have an image of the psychiatrist sitting in a leather chair in a comfortable office, with the patient comfortably and safely discussing his or her innermost thoughts and feelings. Modern psychiatry consists of cramped offices, fluorescent lighting, and straight-backed chairs that are designed to keep patients from feeling too comfortable. The goal is productivity, i.e. seeing as many patients as possible in the time available.”

These problems are not always the fault of psychiatrists or health systems, but rather the result of trends in medicine that affect all specialties. “The principle applied by insurers is that the most expensive care is used as efficiently as possible. On one hand, this allows a psychiatrist to see many more people over the course of the day. But the flip side is that each patient spends the majority of time receiving care from the least-educated, least expensive practitioner. The psychiatrist who spends years in training to understand psychodynamics, personality, and the complex effects of medications gives you only five minutes, and the bachelors-level practitioner spends an hour with you discussing your innermost feelings.” Dr. Junig believes that this inversion of care has the potential for disaster. “Not all psychotherapy is good for a patient. Unfortunately there is an impression that anything called ‘therapy’ must be a good thing. Patients are quite vulnerable when they seek therapy and place a great deal of trust in a person who they know little about. Only a small amount of bad advice can create problems that are much greater than the patient was initially experiencing.”

The growing use of telepsychiatry allows patients to meet with their psychiatrists over telephones or the internet, with or without video. Telepsychiatry is an offshoot of telemedicine, which has been used for years to provide access to specialists for patients in prisons or in geographically isolated areas. Patients using telemedicine usually see the specialist from the office of their primary care physician using video cameras and TV screens. But telepsychiatry takes patient convenience a step further. “With telepsychiatry I can see patients in their own living rooms. They can avoid driving in bad weather or worrying about privacy. They don’t have to sit in waiting rooms, exposed to people with communicable illnesses” explained Dr. Junig. “I have had patients with medical and psychiatric conditions that kept them from leaving their homes, and telepsychiatry was perfect for those situations.” Dr. Junig described benefits that are more subtle that apply to all patients. “A person who is seen in his or her own home feels safe, so it takes less time to establish a therapeutic relationship. In my own telepsychiatry practice, medication appointments are at least 30 minutes long, and psychotherapy appointments are generally 60 minutes. After a short period of time the patient has a sense of connection and support that is not left behind by leaving an office. The reassurance or insight they gain in therapy is more easily applied to their regular lives.”

Dr. Jung explains how telepsychiatry is filling an increasing need for ‘old-fashioned’ psychiatry, while at the same time reversing the ‘inversion of care’ that is too often the norm in modern practices. “The growing acceptance of telepsychiatry allows patients an option beyond the ten-minute appointments with the psychiatrists in their networks. It is not for everybody, as it usually has some out-of-pocket cost. But having time to discuss all of your concerns can mean fewer missed workdays for repeated, ineffective 10-minute appointments. And when you take into account the value of convenience, telepsychiatry offers a valuable alternative to the status quo.”

Jeffrey T Junig MD PhD is the owner of Fond du Lac Psychiatry (www.fdlpsychiatry.com), Medical Director of Nova Counseling Services, and Asst Clinical Professor of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin. He is accepting new patients in his telepsychiatry practice, including Saturday appointments.

He can be contacted through his telepsychiatry web site, http://telephonepsychiatry.com .

###

Visit Fond Du Lac Psychiatry Website

space