YVMC expands Steamboat behavioral health care options with telepsychiatry
STEAMBOAT SPRINGS — The lack of psychiatrists in Colorado and lack of access to behavioral health care “is a statewide crisis, quite frankly,” said Kevin Unger, president and CEO of UCHealth Medical Center of the Rockies and Poudre Valley Hospital.
It is part of a nationwide shortage, as detailed in a 2018 University of Michigan study. The shortage is expected to worsen by 2025 and is having a greater effect on rural populations than metro areas, according to the report.
One approach to increasing access to the limited number of practicing psychiatrists is telepsychiatry — the delivery of services through telecommunication — including psychiatric evaluations, individual or group therapy and medication management.
The technology is growing around the country, and very soon, telepsychiatry will become available in the emergency department at UCHealth Yampa Valley Medical Center in Steamboat Springs. After that, it will expand into primary care clinics.
The new service is part of Wednesday’s announcement that UCHealth is investing $100 million over the next five years to address behavioral health needs for patients across the state.
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“Someone is going to have to step up and take the lead on this,” Unger said.
He described a growing, underserved number of patients in Colorado in need of behavioral health care.
The hospital in Steamboat Springs will be one of four UCHealth locations to participate in the telepsychiatry pilot program. The other part of the $100 million behavioral health investment, which could total as much as $150 million with additional matching and philanthropic donations, will go toward a new patient behavioral health unit in Denver and the integration of behavioral health into primary care. The integration initiative will provide more resources for clinical social workers and psychologists.
Often times, said Unger, when patients have to wait to receive mental health care services, they don’t end up showing up for follow-up appointments.
“More than 380,000 Coloradans aren’t receiving the mental health care they need, 67,000 require substance abuse treatment, and on average, Colorado loses about 1,000 people each year to suicide,” said UCHealth President and CEO Elizabeth Concordia in a news release.
The integration piece is a more proactive approach, said Tracey Fortson, UCHealth Yampa Valley Medical Center’s director of inpatient nursing. When patients go in for medical care, there are often underlying issues — potentially substance abuse, depression or anxiety, she said. Those issues aren’t likely to be solved in a short visit, but the emergency department or primary care practice can connect patients to the best resources and ensure they have the right support once they leave the facility.
UCHealth communications specialist Lindsey Reznicek said the plan locally is to partner with Steamboat area physicians both on telepsychiatry and the primary care/behavioral health integration.
One of the first steps is to identify the existing technology, like the telestroke program, that can be used for telepsychiatry and determine what is still needed.
Fortson said the addition of telepsychiatry in the emergency department will mean many patients don’t need to be transferred to a higher level of care. They also can begin an appropriate medicine regimen immediately, she said, and won’t have to wait a long time for a bed.
“When patients come to the emergency department, they are already in crisis,” Fortson said. “Just like a medical emergency, it is a mental health emergency.”
And the sooner they can access care, the better, she said. People come into the emergency room when they are at a breaking point.
“And compared to a medical emergency, we would never delay services for 24 hours,” Fortson added.
Currently, there are social workers ready to help, but they are unable to provide the same level of evaluation, care and prescription of medications, Fortson said.
Soon, patients will be evaluated in real time on the screen by a psychiatrist, along with the support services being provided by the “boots-on-the-ground” team.
Of course, there is a difference between talking with a person in the flesh and one on a screen. But Fortson notes the prevalence of technology and screen calls. People are used to it, she said. And, there are other social workers and nurses who can provide that in-person support.
There are also a growing number of psychiatrists practicing privately through telecommunications. As the American Psychiatric Association notes, “While some people may be reluctant or feel awkward talking to a person in a screen, experience shows most people are comfortable with it. Some people may be more relaxed and willing to open up from the comfort of their home or a convenient local facility. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life.”
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