Are you hearing voices out there?

noises How many of us have heard stories of how a mentally ill patient claims to hear voices emanating from a television in the room—while it's not on? Then you can understand the skepticism of some practitioners when asked to consider applying telemedicine to the field of behavioral health. And yet, tele-psych programs around the world, and right here in South Carolina, are working successfully to help individuals with behavioral health problems access the care they need.

With 40 percent of returning military personnel from Iraq and Afghanistan wars seen at Veterans Administration hospitals suffering from mental health disorders, the Army has started pilot programs to test the effectiveness of tele-mental health. Initially done out of necessity with troops stationed at remote rural posts far away from doctors in urban facilities, the pilot programs are proving attractive to service members worried that seeking care could damage their careers or undermine their peers' confidence in them. In fact, a recent article in the Army Times cited a study in which a majority of soldiers surveyed said they preferred that the person screening them was far away and that it heightened the sense of confidentiality.

This concern for confidentiality remains strong today with the general public, too, because the stigma of mental illness is alive and well--despite the fact that one in four Americans experiences a mental health disorder in any given year, and groups like the South Carolina Hospital Association are working hard to educate the public and remove the stigma that prevents too many from seeking the care they need. Often individuals needing behavioral health care end up in the emergency department (ED) of a local hospital that does not offer behavioral health services. For the attending physician, the challenge is to locate an available bed or community service provider in the state mental health system — a system that has suffered devastating budget cuts over the last few years.

For that reason, SCHA partnered with the South Carolina Department of Mental Health (DMH) and secured funding from The Duke Endowment two years ago to build a network connecting hospital emergency departments across the state with each other and with DMH. Since March 2007, 17 participating hospitals in our state have accessed more than 3,600 video consults from DMH psychiatrists through the tele-psych network. With the help of these consults, ED physicians are able to get psychiatric patients back on their medications, and participating hospitals are seeing reduced lengths of stay and cost reductions. The South Carolina experience is mirroring the Army's experience — skeptical providers, schooled to place an emphasis on body language and face-to-face contact, are actually finding that today's technology can truly "make distance disappear" and connect the individual patient with the needed expertise. Telehealth is definitely the wave of the future — the day it arrives in your own home is closer than you think!