Telepsychiatry Bridges Gap between Rural and Urban Communities

Currently in the United States, one in five adults have experienced a behavioral health disorder according to the National Alliance on Mental Illness.

Unfortunately, access to mental and behavioral health care in many rural parts of the U.S. is simply unavailable due to a national shortage of mental health professionals. Patients in these rural areas may not know where to seek help and may worry about the stigma attached to seeking mental health care.

“An estimated 96 percent of counties in the United States have some unmet needs for psychiatric patients,” says Pamela Wall, PhD, RN, PMHNP-BC, FAANP, assistant professor at Duke University School of Nursing. “There are an estimated 222,000 licensed nurse practitioners in the U.S. but only 5.4 percent are certified in behavioral health care of the adult or family.”

To respond to the national need for a new generation of mental health providers to reach rural communities, Drs. Pamela Wall and Sean Convoy created the Psychiatric Mental Health Nurse Practitioner (PMHNP) program at Duke. Upon completion of the program, students receive a level II professional training certification in telepsychiatry, allowing them to provide distance-based health care. 

Telepsychiatry is not a new way to administer health care. In fact, Wall was using this method in the military 15 years ago. By using the telepsychiatry model, providers are able to reach at-risk patients who otherwise would likely not be seen and treated.

The distribution of physicians remains skewed towards the northeast United States and in urban areas. For communities outside of these areas, they rely heavily on nurse practitioners to receive their health care. Telepsychiatry is one method for nurse practitioners to provide better access to healthcare in rural regions that may not have a mental health provider nearby.

Students in the PMHNP program develop the knowledge and skills necessary to deliver psychiatric mental health advanced practice nursing care to patients of all ages, especially those in rural and underserved areas. Intensive courses, state of the art simulation techniques and immersion in clinical rotation settings are designed to prepare students to maximize their learning experiences and enable them to become active members of an interprofessional behavioral health care team.  A unique aspect of the Duke program is that students take a course examining the telepsychiatry business model to help prepare them in setting up their own practice upon graduation.

“We’ve chosen to thoughtfully introduce telepsychiatry concepts into the curriculum of our Psychiatric Mental Health Nurse Practitioner Program to allow students to become familiar with this practice,” says Wall.

Outside of Duke, as part of the American Association of Nurse Practitioners (AANP), Wall lobbies in Washington on the federal level and as part of North Carolina Nurses Association, on the state level. Recently, Wall attended the AANP Annual Health Policy Conference, where many believed that telepsychiatry can be important in the treatment of the national opioid crisis.

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