Can Telepsychiatry Address the Pediatric Mental Health Provider Shortage?

January 16, 2025
Can Telepsychiatry Address the Pediatric Mental Health Provider Shortage?

The significant strides made by SSM Health Cardinal Glennon Children’s Hospital in expanding their psychiatric care capacity through telepsychiatry serve as a pivotal example of how modern technology can address persistent healthcare challenges. Based in St. Louis, Missouri, Cardinal Glennon Children’s Hospital provides services to a vast, multi-state region including Missouri, Illinois, Arkansas, and beyond. The hospital has been grappling with a critical shortage of behavioral health providers, a problem mirrored throughout Missouri and many other parts of the U.S. The extent of this issue becomes evident when noting that out of the state’s 1,000 licensed psychiatrists, only about 200 reside in Missouri, serving a population of approximately 6 million people.

Before the COVID-19 pandemic, the shortage in behavioral health services was already a pressing issue, but the pandemic further deepened the crisis. Emergency departments at the hospital saw a surge in behavioral health cases, with patients sometimes held in emergency settings for extended periods, awaiting psychiatric evaluation and placement—sometimes spanning weeks without receiving proper psychiatric care. This untenable situation underscored the severe disparity between provider availability and patient demand, highlighting an urgent need for innovative solutions.

The Widespread Impact of Psychiatric Provider Shortages

This alarming imbalance in provider availability versus patient demand is not confined to specific demographic or geographic sectors but is a pervasive issue affecting urban, suburban, and rural areas across varied socioeconomic backgrounds. Given the hospital’s extensive reach, they must manage this problem on a larger scale, as patients from diverse and widespread regions seek their services. This broad scope of care necessitates robust solutions that can bridge the gap effectively.

Recognizing the acute need to overcome these overwhelming challenges, Cardinal Glennon Children’s Hospital turned to telepsychiatry as a potential remedy. Behavioral health care, unlike many other medical fields, often does not require physical examinations. This characteristic makes it particularly well-suited for telemedicine applications. Consequently, the hospital began seeking vendors capable of providing focused psychiatric support tailored to their pediatric patients’ complex needs.

Choosing the Right Telepsychiatry Partner

After evaluating multiple solutions, Cardinal Glennon Children’s Hospital partnered with Iris Telehealth. The decision was guided by two core reasons: Iris Telehealth’s strong track record of fulfilling commitments at other institutions and their genuine willingness to foster a growth-oriented partnership rather than just maintaining a transactional relationship. The planned approach was designed to scale progressively. Initially, this meant involving one full-time, dedicated telepsychiatrist who would exclusively care for Cardinal Glennon’s patients. The arrangement also allowed Iris Telehealth to provide additional psychiatric capacities as needed, thus offering the hospital the flexibility to optimize workflows before further expanding the program.

Cardinal Glennon’s medical database, Epic EHR platform, played a pivotal role in the program. This platform ensured continuity of care and streamlined documentation processes, nurturing a seamless interface for both providers and patients. Telepsychiatrists interacted with patients through Epic’s integrated video platform, ensuring a cohesive experience. Cardinal Glennon’s team handled various critical tasks before each virtual visit, such as registration, insurance authorizations, and patient readiness assessments, ensuring patients remained committed to their care.

Integrating Telepsychiatry into Existing Care Models

The comprehensive care team at Cardinal Glennon Children’s Hospital includes PhD psychologists, counselors, licensed clinical social workers, and nurse navigators. They closely followed through on the psychiatrist’s treatment directives, providing ongoing therapeutic support. Integrating new telepsychiatrists into this system required approximately three months and involved critical steps like Epic training, hospital privileging, multi-state licensing, and payer enrollment. This integration emphasized assimilating the telepsychiatrists seamlessly into the hospital’s team and culture, treating the program as an integral extension of their existing psychiatric services.

Following the integration of telepsychiatry, the hospital saw remarkable improvements across multiple metrics. Notably, they managed to triple their psychiatric activity volume, significantly enhancing access to care. This increased access was evident by the upward shift in the percentage of new patients scheduled for appointments within 14 days, soaring from 14% to over 60%. As a result, more children were able to receive timely care. Moreover, the rates of no-show and same-day cancellations dropped from 21% to 7%, thus maximizing the utilization of available psychiatric resources.

Impact on Emergency Department and Community Care

SSM Health Cardinal Glennon Children’s Hospital has significantly expanded its psychiatric care capacity through telepsychiatry, showcasing how modern technology can tackle ongoing healthcare challenges. Located in St. Louis, Missouri, the hospital serves a vast region including Missouri, Illinois, Arkansas, and beyond. A critical shortage of behavioral health providers has long plagued the hospital, reflecting a widespread issue in Missouri and many other areas in the U.S. This problem is underscored by the fact that out of 1,000 licensed psychiatrists in the state, only about 200 reside in Missouri, serving around 6 million people.

Before the COVID-19 pandemic, the shortage of behavioral health services was already concerning, but the pandemic further exacerbated the crisis. Emergency departments saw an influx of behavioral health cases, with some patients forced to stay in emergency settings for weeks, awaiting psychiatric evaluation and placement, without receiving appropriate care. This untenable situation highlighted a glaring disparity between provider availability and patient demand, emphasizing the urgent need for innovative solutions.

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