Military provides a blueprint for offering telepsychiatric services

Want to know where psychiatric care is going in the mHealth environment? The military may be giving us a glimpse. With soldiers stationed around the globe, and only so many counseling resources to go around, the Departments of Defense and Veterans Affairs, as well as other agencies are testing out a number of variations on mobile mental health services.

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The latest: A pilot program that would provide counseling services via smartphones or a telehealth connection. The smartphone connection is under development according to the Army Times, and would use basic video-conferencing capability that already exists on most smartphones. "The thing about smartphones is that they aren't tethered to a hard-wired network, so they're highly mobile," David Luxton, a research psychologist and program manager at the National Center for Telemedicine and Telehealth (T2) told the Times. "It works anywhere a service member can get access to a Wi-Fi connection, and it's affordable technology. A lot of people, if they don't have a smart phone, they're getting one."

Already in play is a new "transportable telehealth unit" (TTU). It's a shipping container rigged with webcams and other telehealth equipment, allowing deployed soldiers to talk face-to-face with mental health professionals thousands of miles away. One has been in use in American Samoa since June 2010, and several more are completed and ready for deployment, the Times reports.

The big push is to provide anonymity for soldiers seeking services. "Because it is available 24/7 through online applications and much of our care is available anonymously, which is intentional, [soldiers] can really sample them in a very safe environment without any concerns. Part of what much of our online treatment programs and services do is help normalize what they are experiencing and see if this approach might help them," Gregory A. Gahm, T2 director, told the Defense Media Network in December.

Other military mobile mental health efforts underway:

MoodTracker: Late last fall, the Pentagon offered a new counseling app, MoodTracker, to soldiers and vets, to help them track depression, anxiety and other mental health symptoms. The app provides tips on managing stress, reducing symptoms, and identifying triggers for behavioral problems. The system works through smartphones, although it's only available on Android for now.

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Telepsychiatry for dependents: Tele-mental health, as the military calls it, isn't just for soldiers anymore. Recent announcements indicate telepsychiatric services are provided to military dependents on Fort Drum, N.Y., where one of the most frequently deployed units in the Army--the 10th Mountain Division--is stationed. With family members constantly on deployment, and no on-base psychiatrist available, telehealth is proving an important link in the counseling chain, says Gene Tinelli, an associate professor in the psychiatry department at State University of New York Upstate Medical University.

Mobile mental health education: Through its website, Afterdeployment.org, T2 offers a series of downloadable podcasts for smartphones or MP3 or MP4 players on subjects from depression to self-medicating behaviors to suicide in the military.

So will this technology ramp-up continue? We're betting it will. Recent estimates indicate the Army alone will adding another 1,000-plus mental health professionals to its payroll over the next five years (and spend millions of dollars to do it). With that kind of investment (and Gahm's open admiration for technological solutions to clinical problems), it's certain that the military will integrate mobile technologies wherever it can, to spread those resources over the widest possible patient base. - Sara

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