Abstract

BackgroundOlder adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health") represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1) utility to address existing problematic access to care for rural residents; (2) capacity to reduce stigma associated with traditional mental health care; and (3) utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas.MethodsWe describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology") or traditional face-to-face services ("Same-Room"). Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room). Two-hundred twenty-four (224) male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1) clinical outcomes (symptom severity, social functioning); (2) process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout); and (3) economic outcomes (cost and resource use).DiscussionResults from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery, defined in terms of clinical, process, and economic outcomes, for elderly patients with depression residing in rural areas without adequate access to mental health services.Trial registrationNational Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00324701).

Highlights

  • Older adults who live in rural areas experience significant disparities in health status and access to mental health care

  • The study will test the hypothesis that in-home Telepsychology service delivery will be effective as a traditional mode (Same-Room)

  • If this study demonstrates telepsychology efficacy is equivalent to Same-Room service delivery, future research and program development will focus on bringing a wide range of specialized mental health services to the homes of veterans and community based outpatient clinics via videoconferencing technology

Read more

Summary

Introduction

Older adults who live in rural areas experience significant disparities in health status and access to mental health care. Access to appropriate mental health care services represents a significant problem in many rural and remote areas and as the ageing population expands, this problem will intensify over the several decades without innovative solutions [1,2,3,4]. Access to appropriate mental health care services represents a significant problem in many rural and remote areas and this problem will intensify over the several decades without innovative solutions [4]. In the mental health field, "telepsychology," (or "telepsychiatry" or "telemental health") represents a strategy for potentially addressing this longstanding access to care problem [6,7,8]. The weaknesses identified in the research literature include a paucity of rigorous cost and efficacy studies, for specific populations, and lack of research into the legal, ethical and regulatory issues inherent in this application of technology to clinical practice [6,7,36]

Objectives
Methods
Findings
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call