Current Trends in Child and Adolescent Telepsychiatry
Telepsychiatry is an innovative approach to extend the reach of child and adolescent psychiatrists and fill the gaps in care, particularly in rural or other underserved areas.
We are seeing an increase in the use of telepsychiatry in the primary care setting. Pediatricians often lack adequate referral networks for child and adolescent psychiatrists. A model of telepsychiatrists as consultants to pediatricians allows us to better use scarce resources and reach more children and adolescents. Studies demonstrate that youth suicide rates are higher in rural compared to urban areas and telepsychiatry allows us to bring much needed specialty care to these communities. Furthermore, offering mental health treatment in primary care settings may reduce stigma associated with treatment and thus increase the likelihood of patients seeking these services.
There has been a rapid growth in the use of school-based telepsychiatry. It offers the opportunity to bring mental health treatment to a child’s natural setting and facilitates collaboration with teachers and other school staff. School-based telepsychiatry programs have reported higher follow-up rates compared to traditional community mental health settings.
View all of the topics covered in the Telepsychiatry Toolkit.
Telepsychiatry for emergency psychiatric assessment of children and adolescents is increasing but not well described in the literature. Emergency rooms may have limited or no availability of an on-site child and adolescent psychiatrist. The use of telepsychiatry in this setting has the potential to provide timely assessments of children in crisis, reduce emergency department overcrowding, and prevent the patient and family from having to travel to an urban hospital for assessment.
Telepsychiatry will likely become a routine clinical practice in the future, however most medical students, residents, and fellows, are not regularly exposed to the use of this modality in their training. We are seeing an increase in child and adolescent psychiatry fellowship programs offering telepsychiatry experience to their trainees. The Child and Adolescent Psychiatry Fellowship program at New York University, for example, has developed a resident pediatric telepsychiatry clinic that provides school-based telepsychiatry services to rural areas. Residents and fellows exposed to telepsychiatry in training have an increased comfort level with the technology, may be more likely to consider rural psychiatry, and may be more likely to incorporate this modality into their future practice. View more information on the NYU Child and Adolescent Psychiatry Fellowship.
For more information on practice and clinical issues in child and adolescent telepsychiatry, visit the APA’s Telepsychiatry Toolkit’s child and adolescent page.
About the Author
Dr. Shabana Khan is a child, adolescent, and adult psychiatrist practicing in Manhattan, New York. She is the Director of Telepsychiatry, Department of Child and Adolescent Psychiatry, Child Study Center at Hassenfeld Children’s Hospital of New York at New York University Langone Health.
Dr. Khan graduated from Barnard College with a degree in Neuroscience before attending medical school at the SUNY Downstate College of Medicine. She completed adult psychiatry residency and child psychiatry fellowship at Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh Medical Center (UPMC). Prior to joining NYU, she was an Assistant Professor of Psychiatry, and Medical Director of the Telepsychiatry Service at WPIC of UPMC