Telepsychiatry study shows “statistically significant” improved outcomes for bipolar and PTSD patients

A recently released study funded by the Patient-Centered Outcomes Research Institute found telepsychiatry in rural, federally qualified health centers (FQHCs) was a “resounding success” for those with post-traumatic stress disorder (PTSD) and bipolar disorder. 

 

 

The five-year trial, called The Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT) was designed to “identify the best approach to delivering tele-mental health services to rural primary-care clinics.”

The study took place in Michigan, Washington, and Arkansas with a total of 1,004 participants in 24 FQHCs. John Fortney, Ph.D., lead researcher and professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, said:

“The results of our trial show that if you give access to high-quality care for patients who are underserved, they improve their quality of life.”

Researchers found only one-third of patients with bipolar disorder or PTSD receive mental health care in a year, and just 10% of patients receive adequate care. This study was researching ways to increase access while maintaining equal or better health outcomes. 

The trial compared two telepsychiatry models remotely in participating clinics: tele-referral and tele-collaborative services. Tele-referral services involved one-on-one visits with a licensed clinical psychologist or psychiatrist, while tele-collaborative services involved a telepsychiatrist and care manager supporting visits with a primary care provider. Below is a visual model of the tele-collaborative model. 

 

Image: University of Washington

 

Clinics partnered with state medical schools to provide these services since only 10% of FQHC staff are psychiatrists or licensed clinical psychologists. 

The trial found patients in both groups reported “substantially and statistically significant improvements in perceived access to care, decreases in their mental health symptoms and medication side effects, and improvements in their quality of life.” Paul Pfeiffer, M.D., Michigan-based leader of the study and associate professor of psychiatry at the University of Michigan Medical School, said:

“One of the major contributions of this study is what we knew to be effective for depression and anxiety we now know also achieves good outcomes for patients with PTSD and bipolar disorder.”

The study found no difference in outcomes between the two models and between age, gender, race, or ethnicity. The trial also shows how to distribute available workforce more effectively across primary care clinics. 

Jürgen Unützer, M.D., chair of the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, said:

“We’re at a time now where almost everybody has sort of come to realize what a huge burden untreated mental illness and addiction problems have been.”

A short video documentary of the SPIRIT study was made to highlight real stories of patients who used these services.