It looks as though telepsychiatry, which is rapidly expanding in popularity
in various countries, is limited only by the imaginations of those who want to
As of 2004, for instance, 70 psychiatric interviews using telepsychiatry
had been conducted in prisons in New York state (Psychiatric News,
June 18, 2004). As of 2005, telepsychiatry programs operated by the University
of Colorado Health Sciences Center in Denver were serving American-Indian
patients hundreds of miles away in several surrounding states (Psychiatric
News, July 15, 2005). Quite recently, a young American psychiatrist, who
wanted a working life that allowed her more time with her husband and two
young children, opened a private telepsychiatry practice in her home office.
Even though she is situated in Missouri, all of her patients are in Arizona
(Psychiatric News, July 4).
And now a Canadian psychiatrist—Robbie Campbell, M.D., of London,
Ontario—is using telepsychiatry to make "house calls" on
some 20 Canadian patients with serious mental illness.
As Campbell reported at the Canadian Psychiatric Association annual meeting
in Vancouver in September, "All the patients have to do is touch their
telly screen, and it lets me into their lives! The pictures are very
Thanks to more than 60 Assertive Community Treatment (ACT) teams in the
province of Ontario, which are funded by the province, many Ontario residents
with serious mental illness can now live at home. The ACT teams, which include
primary care physicians, nurses, occupational therapists, social workers, and
consulting psychiatrists, pay such residents frequent home visits.
However, it is physically taxing and financially expensive to have ACT-team
members traveling to the home of each patient up to 14 times a week,
especially when the team members are located at some distance from patients.
So Campbell and his Lawson Health Research Institute team, in partnership with
Telesat Canada and the Canadian Space Agency, received a grant from the
European Space Agency to pilot a project. Its purpose was to see whether it
could enhance the quality of ACT patient care while reducing the cost per
patient so that the money saved could be used to serve more patients.
Although Campbell is located in London, Ontario, he serves as a consulting
psychiatrist to an ACT team headquartered in Woodstock, Oxford County,
Ontario—about 50 miles from London. In his role as consulting
psychiatrist, he treats some 20 patients with serious, persistent mental
illness who live in rural areas of Oxford County. So Telesat installed small
satellite dishes on the houses of these patients and individual telepsychiatry
units in their houses so they could receive telepsychiatry visits from
Campbell without leaving home. Telesat set up similar equipment in
Campbell's London office building so that he could pay virtual house
calls on the patients.
Campbell "visits" each patient via telepsychiatry three times a
week and also in person once a month, he said. Whenever patients need
medication adjustments, hospital pre- and post-discharge planning, or crisis
intervention, he is available by "telly" to assist the ACT team
that provides the patients with hands-on care.
"Patient satisfaction is high and considered by many to be as good
as, or better than, face-to-face visits," Campbell said. "My
patients are also excited about participating in this novel
He has likewise learned that with his routine monitoring of patients via
telepsychiatry, they require hospitalization less often than would otherwise
be the case.
Other ACT teams in Canada might want to consider setting up a similar
telepsychiatry system, he said. ▪