The use of telehealth to increase mental health services access and promote medication adherence in rural locations.

Abstract

Fifteen million residents living in rural locations in the United States struggle with mental illness, substance dependence, or comorbid conditions, and are not receiving adequate health care (CDC, 2017). Approximately 55% of the 3,075 rural communities in the United States lack psychiatric providers. A specialty mental health treatment facility in northeast Florida cannot meet the needs of the patients because of limited psychiatric-mental health nurse practitioner (PMHNP) on site. By design, patients are expected to be seen in the clinic every three months. A pilot project was initiated using telehealth as a venue for patient care as an alternative to a face-to-face consultation with a PMHNP. The project was implemented with adults diagnosed with schizophrenia, bipolar disorder, major depression, posttraumatic stress disorder, anxiety, and/or substance abuse. A 3-month pilot of telehealth consultations with a remote PMHNP tracking access, medication adherence at 30 and 60 days after the consultation, appointment follow-up, and patient satisfaction. Access increased from 4.86% to 10.19% following implementation of the telehealth model. Medication adherence was 82% at 30 days and 77.5% at 60 days, compared to a benchmark of 80%. In addition, 89% of patient responses indicated comfort with telehealth and a willingness to continue to see PMHNPs in this venue. Telehealth with PMHNPs was shown to be a viable option in rural locations to meet the needs of mental health and dual diagnosis patients. Because of this project, the facility increased to three remote PMHNPs in the telehealth role.