Telepsychiatry consultations to a rural nursing facility: a 2-year experience

This report describes the operation of a telepsychiatry consultation service provided from an academic medical center to a skilled nursing facility in a rural setting. Seventy-one consultations via low-cost ISDN videoconferencing equipment were provided over the 2-year period to 40 patients. The average duration of the consultation period was about 3 months. A wide variety of diagnostic conditions were encountered, with the majority being either depression or dementia-related behavior problems. Advantages of the program included the ability to respond promptly to rural patients' clinical needs, the flexibility to consult more frequently if clinically indicated, and more efficient use of the consultant's time, as travel time was eliminated. The program is an example of how telepsychiatry can successfully expand access to mental health services to residents of long-term care facilities.