Video telehealth is key to making mental health services more accessible in regional WA, says psychiatrist Dr Oleh Kay.
Until recently, mental health service provision in rural and remote Australia has long suffered from chronic staff shortages, inadequate access, long wait times and limited Medicare funding. The pandemic, alongside a growing mental health crisis, has only heightened the challenges facing patients and practitioners alike.
The figures speak for themselves. The most recent statistics from the Australian Institute for Health and Welfare reveal that the number of psychiatrists, psychologists and mental health nurses per capita is rapidly declining in regional and remote areas.
There are 3.5 psychiatrists per 100,000 people in remote regions compared to 13 in major cities. This, matched with vastly higher rates of suicide and self-harm in areas outside major urban centres, has created a growing crisis.
Challenges of distance
The obstacles facing people in rural and remote areas trying to access adequate mental health support begins at the first step – accessing a psychiatrist or psychologist in close proximity. And even when there is a practising mental health practitioner, waitlists can be long.
If patients take that first step to reach out for help but are told the services are either unavailable or a wait time counted in months, there is a risk they’ll give up, further exacerbating an already crisis-level situation.
Mental health practitioners in these areas also face issues like burnout and high levels of stress as a result of high demand and limited resources.
Using video telehealth
COVID-19 lockdowns forced many healthcare practitioners to change the way they operated, and this was no different for the mental health sector. My team and I at PsychPlace had to climb a steep learning curve during the first lockdown in March 2020, and during the subsequent snap lockdowns, which forced us to implement a telehealth strategy. Prior to which, our experience with telehealth technologies was zilch, largely due to a lack of Medicare or Department of Veterans’ Affairs rebates.
Video telehealth enabled us to continue seeing patients. Not only that, it enabled the practice to extend its reach to communities in rural and regional WA, helping us provide more support to those who need it.
Prior to the pandemic, patients had to travel from places such as Exmouth and the South West, driving or flying kilometres for appointments. Some had to fly a 1,800km round trip.
The introduction of rebates for psychiatric and psychology telehealth services has been a game changer for patients and practitioners alike.
The video element of our telehealth service is crucial for our practice and our patients. It enables visual engagement between practitioner and patients, creating a closer connection, all without the need to travel.
Telehealth has enabled mental health practitioners to not only maintain the health and safety of our patients during the pandemic but also more easily reach new patients – those who can so easily slip through the system can now more easily access mental health support online via telehealth.
As the government continues to build its post-pandemic healthcare strategy, mental health services and telehealth funding should be a priority. The Federal Government’s pledge to fund a $2.3 billion mental health package, combined with the extension of telehealth until December 2021, is a move that has been welcomed by mental health practitioners and advocates.
However, rebates for mental health appointments via telehealth need to be affordable and we’re still unclear how this is going to look after December. In fact, this is essential if we want a mental health system that is accessible for anyone and everyone that requires care.
Telehealth can be a critical lifeline for those struggling with mental health conditions in regional and remote areas, as well as those who are unable to travel due to health issues.
In areas in which there are a limited number of practitioners, telehealth offers greater flexibility for patients, allowing them to avoid long journeys to the nearest psychiatrist or psychologist and overcome many of the obstacles preventing them from accessing care.
However, telehealth should go hand in hand with building local mental health capacities and services, as both play a pivotal role in creating more equitable access for more Australians.
ED: Dr Oleh Kay is a consultant psychiatrist at PsychPlace. Silvia Pfeiffer, CEO and co-founder of video telehealth platform Coviu, provided input.