Telemental therapy brings mental health doctors to rural areas; some state laws present barriers

Telemental therapy—also called virtual therapy, telepsychiatry or telebehavioral health—is helping to address a severe mental health professional shortage in rural and remote areas, Jon Frandsen reports for Stateline. "Telemental health services, using secure video hookups and high-definition cameras, make it possible for patients to get help without seeing a therapist in person. And the technology allows providers in areas with lower demand to treat patients in areas with higher demand."

South Carolina, which began embracing teletherapy in 2007, "now has telepsychiatry units in 24 ERs across the state that can connect with network providers 16 hours a day, seven days a week," Frandsen writes. Ed Spencer, the head of the state’s telepsychiatry program, said the network treats an average of 400 patients a month and has treated 30,000 patients since being launched.

"Building on the ERs’ success, South Carolina expanded its network of teletherapy providers to 60 public mental health centers and satellite offices statewide," Frandsen writes. A similar program launched in North Carolina in 2010 and in 2013 was expanded statewide through 2017. (Dark blue states participate in the Interstate Medical Licensure Compact. For an interactive version click here)

One barrier has been state laws "that can make it difficult to practice teletherapy across state lines," Frandsen writes. "The biggest barrier, perhaps, is licensing. States generally require that doctors be licensed in the same state as the patient they are treating. That could mean a mental health care provider would have to have multiple licenses to treat patients across state lines."

"Some states work out license reciprocity arrangements, especially with neighboring states," Frandsen writes. "New Jersey, which generally lags behind most of the rest of the country in updating its laws to address telemedicine, passed a law in 2014 that allows for reciprocity as long as the other state license is in line with New Jersey’s license requirements."

"State compacts that make one license acceptable among all the member states are another solution backed by telehealth providers," Frandsen writes. "Some critics, however, argue that the compacts give too much power to medical and other professional boards, which can make regulations more restrictive, not less. Seventeen states have signed on to such a compact covering doctors, including psychiatrists. But compacts covering other types of mental health practitioners such as psychologists, family therapists and therapeutic social workers are still being drawn up." (Read more)