INTEGRATING TELEPSYCHIATRY BASED CARE IN RURAL ACUTE COMMUNITY MENTAL HEALTH SERVICES? A SYSTEMATIC LITERATURE REVIEW

BACKGROUND: There is limited local literature specific to emergency department assessment and subsequent telepsychiatry follow up in the community and most literature on telepsychiatry does not cover the case of urgent assessment and crisis follow up in the community. AIM: This literature review explores the use of videoconferencing technology to overcome the burden of distance and access to tertiary mental health services in regional and remote areas of Australia. METHODS: A systematic search in Medline, CINAHL, Psychiatry Online, Google Scholar, and the NSW Health Clinical Info Access Program (CIAP) was conducted. A combination of key terms: "Telepsychiatry" OR "Mental Health Telemedicine" OR "Telemedicine" OR "Telehealth" OR "Videoconferencing" OR "Mental Health Videoconferencing" OR "Telepsychiatry Ethics" AND "Acute Community" AND "Emergency Assessment" were used. Based on the screening and eligibility criteria, 21 peer-reviewed articles published in English between 2005 and 2020 were included in the review. RESULTS: Key themes were found which support the use of remote telepsychiatry. Common in the literature were themes of equivalence to in-person review, as well as themes of convenience, overcoming remoteness and timely access to specialist assessment. Ethical and technical considerations was also commonly cited. The literature search found no direct examples of an acute psychiatric assessment in the emergency department with a subsequent follow-up in the community using videoconferencing technology. CONCLUSION: Telepsychiatry in both the home and emergency department areas had merit and equivalence to face to face review, with the added benefit of wider access and timeliness to specialist assessment and treatment.