Review Article Open Access
Noblin et al., J Health Med Informat 2012, S7
DOI: 10.4172/2157-7420.S7-001
J Health Med Informat ISSN:2157-7420 JHMI, an open access journal
Virtualized Medical Systems
Keywords: Rural Health; Telemedicine; Telepsychiatry; Mobile
Health
Introduction
In the United States, mental illness is the leading cause of disability
for individuals aged 15 to 44 years [1] and is one of the leading
indicators identifed by Healthy People 2010 [2]. While mental health
issues are prevalent everywhere, research shows that those patients
located in rural settings sufer worse outcomes and are more likely
to commit suicide than their urban counterparts [3]. Research has
demonstrated that a patient sufering from mental illness in a rural
setting is more likely to receive generalized medical care, and less likely
to receive specialized mental health care than their urban counterparts [4].
Tis indicates a gap in the quality of care experienced by over half of the
counties in the United States that have no mental health professionals [5].
One key factor in the provision of adequate mental health services
in rural areas is the availability of specialized health care providers.
While the supply of specialists is increasing overall, a geographic
maldistribution of all physicians exists and a lack of specialized care
exists in rural areas [6]. Several phenomenons infuence this lack of
specialized care. First, the rural healthcare force is aging, and thereby
shrinking [7]. Second, there is evidence that supports the idea that
lifestyle preference of young physicians dictate that they do not want
to practice in more rural areas [8]. Reasons for this are opportunities
to earn a higher income, more professional interaction, better access
to contemporary medical facilities and technology, increased cultural
diversity, an increased availability of social and recreation activities [6],
and an inadequate patient supply to provide fnancial sustainability for
physician practices [9].While several programs, such as loan forgiveness
programs available to physicians who practice in underserved areas, the
National Health Service Corps, and Migrant and Community Health
Center Programs have been implemented, they have typically not
addressed mental health professional shortages [6].
In light of the need for mental health services in rural populations,
and the apparent lack of traditional medical services, the use of
telehealth, and in particular, telepsychiatry has proven to be a viable
solution to these issues. Te aim of this paper is to investigate the need
for telepsychiatry services, explore the current trends in this area, and
ofer solutions on both a broad policy perspective and an individual
practitioner level.
Background
Te state of rural America
In the United States, the Mississippi River divides two distinctly
diferent forms of rural America [10]. Te eastern side of the country
is more densely populated with small towns spread along highways and
back roads. West of the Mississippi is a more sparsely populated area,
with wide open spaces between the metropolitan areas. Te scarcity of
populations translates into difcult and expensive travel distances for
health and mental health care.
Te demographics of this wide variety of rural Americans ofer some
similarities. Unemployment and poverty are higher in rural America
than in urban areas. More than half of children in rural American homes
live in poverty, with single mothers as head of household [10]. Children
*Corresponding author: John Cantiello, Department of Health Administration and
Policy, George Mason University, USA, Tel: 703-993-1731; Fax: 703-993-1953;
E-mail: jcantiel@gmu.edu
Received February 25, 2012; Accepted March 08, 2012; Published March 14,
2012
Citation: Noblin A, Ward CK, Cantiello J (2012) Utilizing Telemedicine Techniques
to Confront Rural Mental Health Care Challenges: The Progressions towards a
Technological Health Ecosystem. J Health Med Informat S7:001. doi:10.4172/2157-
7420.S7-001
Copyright: © 2012 Noblin A, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Abstract
Due to the unique population characteristics of Rural America, the diagnosis and treatment of medical conditions is
a challenge. This is especially true when specialists are needed, in particular for mental health care including psychiatry.
Provision of care often falls to primary care providers, who may fail to recognize symptoms or misdiagnose a condition.
In addition, a stigma is often attached to mental health issues and precludes many people from seeking treatment,
particularly due to embarrassment and perceived confdentiality issues.
This paper will describe the rural population and mental health issues faced by patients and providers. Challenges
will be explored from a systems theory viewpoint, as well as from community development perspectives. Solutions will
be offered ranging from the broad theoretical perspective including policy options, and specifc solutions for practitioners
in various settings.
Of particular focus is telemedicine in the form of telepsychiatry. This option is mentioned throughout this paper in
terms of current usage in specifc settings as well as provider and patient acceptance of the technology. Telemedicine
utilizes computer technology to transmit data, voice, video, and a combination of the three with live video feeds. This
implies the technology is available not only in terms of computers and other hardware, but also the infrastructure, or
availability of internet connection. In rural areas, this may require satellite based internet connections or other options.
Utilizing Telemedicine Techniques to Confront Rural Mental Health Care
Challenges: The Progression Towards a Technological Health Ecosystem
Alice Noblin
1
, Kendall Cortelyou-Ward
1
and John Cantiello
2
*
1
Department of Health Management & Informatics, University of Central Florida, USA
2
Department of Health Administration and Policy, George Mason University, USA
Journal of
Health & Medical Informatics
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ISSN: 2157-7420