The brain's center of gravity: how the default mode network helps us to understand the self

ority may help reassure reluctant users. Another challenge is the confusing legal landscape within which telepsychiatry practice occurs. Depending on the country, this may involve adhering to a complex web of federal and regional legislation. In the US, for example, treatment must adhere to federal laws that predate current telemental health tools (e.g., the Health Insurance Portability and Accountability Act of 1996). The result may be that crucial questions in telepsychiatry practice remain unanswered, such as whether ubiquitous tools like FaceTime and Skype meet the requirements of health care technology legislation. Also, in the US, where licensing laws are regional and deem care to occur in the state where the patient resides, cross-state treatment is severely limited, a reality that neutralizes a key telemedicine value proposition – correcting shortages in access to care. The dearth of guidance from leading professional organizations has also limited telemental health adoption. The first major telemental health initiatives by the American Psychiatric Association and the American Psychological Association, for example, date back only to 2015 and 2011, respectively. This has contributed to confusion among practitioners regarding treatment “best practices”, remote management of emergencies, reimbursement, insurance coverage, malpractice protection, documentation, product vetting, and security. More guidance is required if providers are to embrace promising novel treatments thatmay comewith heightened risks. Further, certain telemental health tools have not escaped automatic comparisons with video games or other online or technology-enabled entertainment. This is particularly true within the field of “serious games”, defined as video games with educational or therapeutic goals, and virtual reality therapy. Especially when infrastructure investment can be significant, interventions that are perceived as entertaining but not necessarily therapeutic will struggle to gain footing. Indeed, infrastructure, while significantly less expensive now, as evidenced by the decrease in the price of virtual reality equipment, is still not universally affordable. This represents an ongoing challenge to wider adoption; one that mirrors technical know-how, which – while no longer the obstacle it was, due to increased technology literacy and ever more “plug and play” models – still represents a challenge in certain populations. The unmet needs in mental heath care are too large to be addressed without leveraging technological innovations. Mental health care is particularly well suited to benefit from telemedicine advances, but several obstacles have made it so that the telemental health revolution, with its promised solutions, has not yet arrived. Concerted efforts by funding agencies, researchers, engineers, public health authorities, professional organizations, and legislative bodies are needed if the hope is to translate into real-life improvement.