Solving Mental Healthcare Access Problems in the Twenty-first Century

Technology is the key to solving mental healthcare access problems in the twenty-first century. Perhaps the greatest challenge we face in harnessing the possibilities of information technology in healthcare today is to ensure that we do it in a manner that is clearly evidence-based. This means innovations must be evaluated in a variety of contexts, using designs to ensure they are feasible and acceptable to our patients, are effective in treating the symptoms and disorders for which they are applied, and ultimately are structured to have the best possible balance of increasing access, minimising costs, and maximising clinical outcomes. As a service delivery medium, telemedicine, or telepsychology, offers a viable means of delivering high quality, specialised mental health services to people with significant access-to-care barriers, such as those living in remote or rural areas, lacking in transportation, or experiencing ambulatory problems such as many elderly people do. Randomised controlled trials have demonstrated the clinical efficacy of telemedicine for specific populations with discrete psychiatric disorders. Going forward we must discover how to best integrate telemedicine with in-person care and other forms of communications technology, including the Internet, mobile technology and its "apps", social media, virtual reality, "smart homes," and wearable monitoring devices. It is also imperative that we better integrate these approaches with primary medical care so that "mental healthcare" does not continue to be viewed as independent from physical health.