In recent years, North Carolina faced high Emergency Department (ED) admissions related to an increase in behavioral health issues. It has been reported by the North Carolina Department of Health and Human Services (DHHS) that more than 25 percent of individuals experiencing mental health crises that were admitted to EDs, return to the ED within 30 days.
The fact is that fifty eight counties in North Carolina now qualify as Health Professional Shortage Areas due to a lack of mental health providers. This is one of the reasons that mental health patients have been a growing burden for the state’s EDs and make up to 9.3 percent of ED visits.
The majority of the state EDs do not have access to a full time psychiatrist. Currently, there are 108 hospitals with either single EDs or in some cases multiple site EDs across the state that operate with varying degrees of psychiatric coverage.
To counteract the problem, Governor McCrory of North Carolina recently announced that a Statewide Telephsychiatry Program is being developed for the state to help individuals in emergency rooms have access to mental health professionals if a mental health or substance abuse issue is in a crisis mode.
The state will invest $4 million over two years in the telepsychiatry program which will be overseen by the HHS Office of Rural Health and Community Care.
The statewide telephsychiatry program due to begin operations January 2014 is built on the success of East Carolina University’s (ECU) Center for Telepsychiatry and e-Behavioral Health and the Albemarle Hospital Foundation Telepsychiatry Project.
The ECU Center’s program is going to establish the technology infrastructure and guidelines for administering the program. In addition, an advisory group will work to promote collaboration among partners. The hospitals in the ECU program have seen the average patient length of stay in the emergency department reduced to less than 24 hours.
The Albemarle Hospital Foundation telepsychiatry program started in 2011 has been able to make more than 4,000 psychiatric assessments for patients in EDs experiencing a mental health crisis. The Albermarle program funded by a three year $1.6 million grant from the Duke Endowment is now partnering with Vidant Health and the East Carolina University Brody School of Medicine.
The Statewide Telepsychiatry Program will use secure, real-time interactive audio and video technology to enable a mental health provider to diagnose and treat individuals needing care at any remote referring site.
The system involves the nurse rolling out a portable cart outfitted with a monitor, camera, and microphone into the patient’s bay or room. Then the nurse then establishes a secure link to the psychiatric provider site and introduces the patient to an intake specialist on the other end that has already reviewed the patient’s information.
The psychologist or social worker explores the patient’s situation and gathers more information from family members. At this point, a psychiatrist interviews the patient and makes a recommendation to the referring hospital physician who is ultimately responsible for care decisions.