Patients dial in to tele-psychiatry
Thursday, December 17, 2009
WENATCHEE — The nearest psychiatrist is a two-hour drive to Wenatchee, but Carrie says it’s worth it to see her 15-year-old daughter emotionally stable.
Her daughter is undiagnosed, but Carrie believes she suffers from bipolar syndrome and attention deficit disorder. Carrie and her daughter, who asked not to be identified to protect her daughter’s identity, have been seeing Dr. Kathleen Myers for medication management since 2005
Myers isn’t really in Wenatchee. She’s on television.
About once a month, the mother and daughter drive from their rural town to Central Washington Hospital. They sign in and sit in a waiting room until a nurse calls them into a tiny room with chairs, a camera and a computer hooked up to a 36-inch TV.
The appointment is a video conference. When Myers calls in, Carrie and her daughter can see her on screen, live from her desk in Seattle Children’s Hospital. Likewise, Myers can see Carrie and her daughter in Wenatchee. They talk and interact with a millisecond delay.
“It’s a little bit of the unknown. We’re sitting in front of a television talking to a doctor. It’s kind of odd,” Carrie said. “You get into the groove quickly. It’s one of those things if you want to see a specialist, you do what you need to do.”
Myers one of about four telepsychiatrists serving the North Central Washington, where specialists are few.
From Seattle, Myers can diagnose, manage medication and help parents and children develop the skills they need to cope. Overall, the telemental health team at Seattle Children’s Hospital spends about six hours per week with NCW children, ages 2 to 21.
Karen Mathers of Wenatchee said her 14-year-old son Thomas Jr. gets more out of telepsychiatry than face-to-face appointments. The boy was diagnosed with attention deficit hyperactivity disorder (ADHD) and Asperger’s Disorder, which is a mild form of autism.
“With hyperactive kids, if get too stimulated then they’re like a ping pong ball in a box,” Mathers said. “I notice that when we go do telemed with Dr. Myers there’s less stimulation and he doesn’t react as much.”
Thomas Jr. is brilliant at building structures and knowing how they work, Mathers said. He has the mind of an engineer, but his hyperactivity causes him to act out in school. He’s working with Myers to find the right medication that will help him focus and stay calm, Mathers said.
“It’s nerve-wracking because everyone wants your kid to be normal, and they’re not,” Mathers said. “When you see an expert, they don’t want your kid to be normal, they want your kid to be productive. That is so much more helpful.”
Myers is leading a team of psychiatrists and therapists in the first federally-funded clinical trial of telemental health. They received a $3 million grant from the National Institute of Mental Health to compare how kids with ADHD react to telepsychiatry versus treatment with a pediatrician.
The plan is to recruit 250 children, ages 6 to 12, and randomly assign half of them to pediatrician care for 18 weeks. The other half will participate in six sessions of telepsychiatry and parent management training.
So far, about 15 children have been evaluated.
The families will be paid $210 in six increments: The initial screening, four evaluation check-points and after the last session.
“The hypothesis is that kids in both groups will improve but that the kids who get the full telemental health intervention will do better,” Myers said.
Doctors are getting better at treating ADHD, but they are not often trained in helping kids through problems with school or the law. About 70 percent of kids with ADHD also have a learning disability or anxiety, Myers said.
“Ultimately, we are hoping this study will demonstrate the effectiveness of telemental health so that insurance companies will be compelled to pay for telepsychiatric care. In that way, all children can have equal access to services,” she said.
Rachel Schleif: 664-7139
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