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TeleMental Health for Troubled Teens

MUSC Offers TeleMental Health Services to Teens and Adolescents

Since March 2011, MUSC’s Department of Psychiatry & Behavioral Sciences has provided telemedicine-based psychiatric care at New Hope, a 150-bed psychiatric residential treatment facility for adolescents in Rock Hill, SC. Treating these troubled teens, many of whom have serious mental illnesses, some of whom have a history of sexually aggressive behavior, and some of whom have below-average IQs, can be challenging. Before the institution of the telemental health program, one full-time and one half-time psychiatrist served the needs of these patients on site. Burnout and turnover were high because of the challenging patient population and the long hours, and positions were difficult to fill because most mental health professionals prefer to live in more urban areas.

MUSC’s telemental health program for troubled teens solves this problem, providing the services of three licensed psychiatrists who can rotate their schedules to prevent burnout and ensure round-the-clock coverage. MUSC psychiatrists provide initial psychiatric evaluations and medication management as well as weekly sessions with patients to review symptoms, medications and general well-being. They travel to Rock Hill once a month for consultation but otherwise provide all services via telemedicine.

Hugh Myrick, M.D., Associate Professor of Psychiatry & Behavioral Sciences and Medical Chief of the Center for Drug and Alcohol Programs at MUSC and Associate Chief of Staff for Mental Health at the Ralph A. Johnson VA Medical Center, directs the telemental health program and provides after-hours call coverage. Dr. Myrick has noticed that after-hours calls have gone down considerably since the program began because of the more intensive case management and emphasis placed on process improvement by the MUSC psychiatrists. According to Eric Baumgartner, Chief Operating Officer of New Hope, the MUSC team is “highly involved in looking at our current systems and how we can improve and be a part of that process.”

The collaboration has benefitted New Hope’s adolescent patients. Baumgartner notes that a number of them may have been denied continued treatment by the agencies funding the care had it not been for intervention by the MUSC psychiatrists who knew the cases in detail and were able to convince the agencies that the adolescents would benefit from further care. The MUSC psychiatrists are also better able to treat comorbid medical conditions that could be contributing to patients’ mental illness. Intrigued by the technology, adolescents also respond well to the program. They are also less likely to resist participating in a telemedicine session because the authority figure is not physically present and so does not arouse automatic resentment.

It has also been a cost-saving collaboration for New Hope. According to Baumgartner, “it is significantly more expensive to have a full-time psychiatrist on benefits and a part-time psychiatrist than it is to pay three telepsychiatrists, one on-call telepsychiatrist and a local part-time psychiatrist—we get more service hours from the telemedicine model with less expense.”

To discuss contracting for telemental health services with MUSC’s Psychiatry & Behavioral Sciences, call MEDULINE at 1-800-922- 5250 or 843-792-2200 and ask to be connected to Dr. Hugh Myrick.

References

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