Telebehavioral health improves access to care and leverages scarce resources in rural settings

In a recent review, Donald Hilty and colleagues review the last 10 years of literature on telehealth in rural settings. These researchers identify recurring themes from research on providing virtual culturally competent care in these rural settings.

Culturally Competent Care (foundations, approaches, training options): It is important to provide patients with options for primary vs. secondary language, in-person vs. telehealth (pre-/post-COVID), culturally matched vs. unmatched clinicians, and interpreter services. Exploration of identities and self-definition, strength-based approaches to building resiliency, and culturally adaptive interventions are recommended.

Physician and Workflow Barriers of Telepsychiatry and Telebehavioral Health: Established barriers for telepsychiatry include concern about establishing rapport and assessing non-verbal signs of psychiatric illness, as well as additional time to organize and coordinate telebehavioral health visits. Ways to ameliorate these issues include: Orienting patients and staff to telebehavioral health platforms and procedures, establishing clinician-distant sites, occasionally integrating in-person visits, and use of asynchronous patient questionnaires and screening tools.

Successful Administrative Approaches: Using telebehavioral health to consult with clients to triage, diagnose, and create/modify treatment plans may save resources, help patient accessibility, and make future in-person treatment more effective.

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