Provider Satisfaction from a New Telepsychiatry Inpatient Consultation Service.

Background:Telepsychiatry is a well-studied modality that has been shown to perform as well as, if not better than, in-person mental health services. However, acceptability of this modality to practitioners, especially as it relates to the type of consult, has not been well studied. To address barriers to implementing a new telepsychiatry consultation-liaison (CL) service at a rural campus of a large tertiary care health network, authors designed a survey to assess consultee attitudes before and after the service launch. A secondary objective was to examine the consult data.Materials and Methods:The new telepsychiatry CL service at the rural hospital was delivered by providers at the main campus of the health network. Authors surveyed all consultees before the launch and every 3 months for 12 months thereafter. Consult data was also tracked in that same period.Results:Over a 12-month period, 442 initial and follow-up consults were completed. Consultees were most concerned with assessing delirium, agitation, and neurocognitive disorder over live video. Consultees generally held their belief that telepsychiatry consults are not as enjoyable as in-person consults, but they recognized its value, specifically regarding improved access for patients.Discussion:The service was successfully launched and was well received as evidenced by the continued use of the service.Conclusions:The project revealed valuable insight which has been used to improve the service and to replicate it at another campus within the health network.

Universal versus risk factor-targeted early inpatient postpartum depression screening.

OBJECTIVE: To assess differences in two different approaches to early inpatient Edinburgh Postnatal Depression Scale (EPDS) screening (targeted risk factor screening versus universal screening). METHODS: Retrospective study of two cohorts delivering from January 2010 to June 2010. Cohort 1 included 5-weeks of consecutive deliveries. Risk factors for a positive EPDS screen were determined by multivariable logistic regression. Cohort 2 included all delivering women in the subsequent 5 months who had the most common risk factor (history of mental illness) for postpartum depression identified from Cohort 1. RESULTS: For Cohort 1 of universal screening (N = 322), 11 (3.4%) had positive screens with seven (63.6%) having a history of any mental illness yielding the number needed to screen to identify one EPDS positive mother of 29. For Cohort 2 (N = 215), there were 33 (15.3%) positive screens and the number needed to have a positive screen was 6. Without a history of mental illness, predictive models for a positive screen were poor with the number needed to screen of 80. CONCLUSIONS: Early EPDS screening targeted for those with a history of mental illness is an efficient way to identify postpartum women with active mental health problems, but may miss up to 36.4% of potential screen positive women.