Using video chat to access mental health treatment

SAFE AND SECURE: One benefit of telehealth consultations for rural and remote patients is the feeling of confidentiality it provides.
SAFE AND SECURE: One benefit of telehealth consultations for rural and remote patients is the feeling of confidentiality it provides.

Seeing how difficult it was for patients to navigate the mental health system was one of the reasons psychiatrist Dr Ben Chia set up his telehealth mental health practice Call to Mind which uses video chat technology to provide patients with access to psychiatrists and psychologists.

"Even those in the metropolitan area struggle to find a good mental health clinician that they can work with, let alone those in the rural and remote regions," he said.

"We have a wide range of clinicians from all over Australia and when a referral comes in we can find out who is best for that person so they don't have to do all the searching themselves. Patients are able to review the list of available clinicians and indicate who they think they would work well with."

Mental health in rural and remote areas has received attention lately with a review of the mental health system finding rates of mental illness and suicide continue to rise in Australia, even with increased spending in the area.

This has led to the establishment of the National Mental Health Commission's Productivity Commission to determine better ways of delivering mental health care to the community.

Demand for face-to-face psychiatric services is so high that some metropolitan clinicians are unable to take new patients.

For those who do, their patients can face a three-month waiting period for their first consultation.

Waiting times for initial telehealth psychiatric consultations can be as little as one week, and are more flexible than the standard office hours offered by traditional services.

Dr Chia said his team, comprising psychiatrists and psychologists, routinely refer their patients between each other in order to draw on each other's strengths and areas of expertise.

"There is a wide range of approaches to treatment of mental health conditions, and using the wide range of skills, expertise and experience within our team allows patients to have the best chance of recovering from their illness," he said.

Patients are supported by Call to Mind to find the practitioner who would be the best fit for them, schedule the appointment, and do a test video call to ensure when the consultation takes place there are no technical problems.

The system was developed by the CSIRO to be secure, high quality video that is easy to use. It is accessed through the user's web browser without the need to download extra software, and the system is able to adjust the quality of the video to suit the speed of the internet connection.

Psychiatrists bulk-bill the initial assessment (up to four one-hour sessions). For ongoing treatment there are out of pocket expenses between $50-100, but some psychiatrists and psychologists may also bulk-bill or make allowances for financial hardships, such as those living on pensions.

Dr Chia said another benefit of telehealth consultations for rural and remote patients is the feeling of confidentiality it provides.

"In a small community it might be hard for you to talk about your problems to your psychiatrist or your GP who you also see at the shops," he said.

The patient's treating GP will receive treatment updates from the clinic, however the patient can elect to keep certain information confidential, which will not be passed onto other medical professionals.

Interpreting services are available for those who communicate in AUSLAN or who do not speak English.

Carers are welcome to attend sessions for cognitively impaired patients just as they would for other medical appointments.

"There have been a lot of studies done on this type of psychotherapy, and it has shown that video conferencing doesn't affect the ability for people to develop a rapport with their clinician," Dr Chia said.

Some people even prefer it, as they are in their own homes and they don't have to travel to a clinic and spend time in a waiting room. It can also be particularly suitable for patients with anxiety disorders, physical disabilities and those living in residential aged care facilities.

Eligibility for Medicare rebates for access to telehealth

To see if you are eligible for telehealth under Medicare, go to doctorconnect.gov.au/locator

Patients located in ASGS Remoteness Area (2016) RA2-5 are eligible for Medicare to see a psychiatrist.

Patients located in Modified Monash Model (2015) MMM4-7 are eligible for Medicare to see a psychologist.

For FAQs regarding telehealth, see calltomind.com.au/faq/

For help, contact Lifeline 131 114 or lifeline.org.au, beyondblue 1300 224 636 or beyondblue.org.au, SuicideLine 1300 651 251 or MensLine 1300 789 978.

For more information visit HealthShare, a joint venture with Fairfax to improve the health of regional Australians. Or you can find a specialist near you using the health tool below.