Telepsychiatry with Children and Adolescents in Community Mental Health Settings
Lynda Lee Carlisle, MD, DFAACAP


  • Federal mandates that have increased the eligibility of children and adolescents for mental health care have not comparably increased the capacity for services.
  • In non-metropolitan communities, youth often receive their mental health care at community mental health centers.  Child and adolescent telepsychiatrists can provide the psychiatric services that are not available locally.
  • There is often a wide variety of staff specialists at community mental health centers, and they may not be child-trained. Many are not yet licensed, or are working toward advanced degrees. Child and adolescent telepsychiatrists may play an important collaborative role to upgrade evidence-based, child-specific services and bolster support networks. 
  • Psychiatrists providing telepsychiatry to rural areas can help to build capacity and bridge the access-to-care gap by referring youth back to their primary care provider for medication management after evaluation and/or stabilization. This collaboration can open telepsychiatrists’ schedules more quickly to increase access and provide a resource for primary care providers.
  • Staff and administrators at community mental health centers may need some education to learn how to work remotely with psychiatry, to appreciate its benefits, and to overcome limitations.
  • Child and adolescent telepsychiatrists must learn how to work within the structure and resources available in under-resourced community mental health centers in distant communities.

References

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  3. U.S. Department of Health and Human Services. Patient Protection and Affordable Care Act (ACA); Public Law 111-148; 2010. https://www.govinfo.gov/content/pkg/STATUTE-124/pdf/STATUTE-124-Pg119.pdf
  4. Thomas K, Ellis A, Konrad T, Holzer C, Morrissey J: County-level estimates of mental health professional shortage in the united states. Psychiatric Services 60:1323-1328, 2009.
  5. The Muskie School of Public Service. The Role of Community Mental Health Centers as Rural Safety Net Providers Working Paper #30 November 2002;  https://muskie.usm.maine.edu/Publications/rural/wp30.pdf  Accessed July 1, 2018.