Telehealth and rural depression: physician and patient perspectives.

Due to a shortage of mental health professionals (MHPs) in rural areas, primary care physicians (PCP) are often the first, and in many cases, the only providers of depression treatment for rural individuals. This study was an investigation of the acceptability of behavioral telehealth to PCPs and patients with depression as a way of making mental health treatments more accessible to rural patients. The researchers conducted 10 focus groups across rural Nebraska with PCPs and patients they had treated for depression. A qualitative multiple-case study approach was used to analyze the transcriptions. The participants felt that behavioral telehealth is a reasonable solution to the access-to-care problem. They expressed concern that professional and therapeutic relationships would be difficult to maintain at a distance and they provided suggestions for how to preserve these relationships when using technology to deliver treatment such as focusing on fostering collaborative relationships between MHPs and PCPs. It is essential for MHPs and PCPs to develop and maintain a collaborative working relationship that will facilitate frequent communication.

[1]  J. Susman,et al.  Depression in rural family practice. Easy to recognize, difficult to diagnose. , 1995, Archives of family medicine.

[2]  J. Greenhill,et al.  Rural and Remote Health , 2009 .

[3]  D. Crane,et al.  The influence of marital and family therapy on health care utilization in a health-maintenance organization. , 2000, Journal of marital and family therapy.

[4]  J. Fortney,et al.  Treatment of depression in rural Arkansas: policy implications for improving care. , 1999, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[5]  G. Goldfield,et al.  Delivery of family therapy in the treatment of anorexia nervosa using telehealth. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[6]  J. Geller,et al.  Rural primary care providers' perceptions of their roles in the provision of mental health services: voices from the plains. , 1999, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[7]  J. Patterson Mental Health Professionals in Medical Settings: A Primer , 2002 .

[8]  M. Booth,et al.  Health and access issues among Australian adolescents: a rural-urban comparison. , 2003, Rural and remote health.

[9]  Joseph L. Antonowicz,et al.  Families, Illness, And Disability: An Integrative Treatment Model , 1994 .

[10]  E H Wagner,et al.  Improving depression care: barriers, solutions, and research needs. , 2001, The Journal of family practice.

[11]  Harriet P. Lefley,et al.  Families, Illness, and Disability: An Integrative Treatment Model , 1995 .

[12]  C. Robbins,et al.  Rural interdisciplinary mental health team building via satellite: a demonstration project. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[13]  H. Christensen,et al.  Internet-based mental health programs: a powerful tool in the rural medical kit. , 2007, The Australian journal of rural health.

[14]  R. Bischoff,et al.  Addressing the Mental Health Needs of the Rural Underserved: Findings from a Multiple Case Study of a Behavioral Telehealth Project , 2004 .

[15]  D. Hartley,et al.  Service use of rural and urban Medicaid beneficiaries suffering from depression: the role of supply. , 1999, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[16]  Rita Kobb,et al.  Making the right connection: matching patients to technology. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[17]  N. Korsen,et al.  Management of patients with depression by rural primary care practitioners. , 1998, Archives of family medicine.

[18]  Mark A. Hubble,et al.  The heart and soul of change: What works in therapy. , 1999 .

[19]  Sharan B. Merriam,et al.  Qualitative research and case study applications in education , 1998 .

[20]  Jon D. Elhai,et al.  Attitudes Toward Medical and Mental Health Care Delivered Via Telehealth Applications Among Rural and Urban Primary Care Patients , 2008, The Journal of nervous and mental disease.

[21]  R. Spitzer,et al.  Patient Health Questionnaire-9 , 2011 .

[22]  S. McDaniel,et al.  Medical Family Therapy: A Biopsychosocial Approach To Families with Health Problems , 1992 .

[23]  K. Lessing,et al.  Mental health telemedicine programmes in Australia , 2001, Journal of telemedicine and telecare.