Telemental Health Fills Rural Health Care Gap

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One way rural communities are shoring up their health care options, given a notorious dearth of doctors of all stripes, is by turning to telehealth. With broadband spreading to Minnesota's smallest towns and farms, it's becoming possible for even the most remote patient to see, by camera and video monitor, a doctor hundreds of miles away.

Telehealth has been used for dermatology and endocrinology, among other specialties. But it works especially well for mental health care, say advocates, since counseling doesn't require a physical examination. Telemental health also allows rural people to receive care in a hospital or general clinic, eliminating the stigma that comes with parking in front of a therapist's office.

Often, when a patient sits before that camera for a session, the doctor they're talking to is Jane Hovland, a nurse, licensed psychologist, and associate professor at the U of M Duluth. Rural people, says Hovland, who was raised in northern Minnesota, "are such a self reliant bunch." When it comes to mental health, "We expect people to figure it out on their own."

But the fact is, some can't. The most common diagnosis Hovland makes is of major depression, followed by anxiety disorders.

Hovland notes that Minnesota has more psychologists than the national average. But they tend to practice in the city. "There are 13 counties without a single licensed psychologist," she says. "It's a matter of distribution." That's why doctors with the U's telemental health program have seen 2,300 patients over the past five years.

"I had a client who would ride a bicycle in from the woods for telemental health appointments," Hovland says, noting that because the U sees patients quickly, the no-show rate is very low. "We're trying to show that this is a sustainable model," she says.

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