Improving Treatment Outcomes For American Indians With Posttraumatic Stress Disorder Through The Use Of Telepsychaitry
The prevalence of PTSD has increased from 6.8% to 20% since the start of the Covid-19pandemic. For American Indians, the prevalence of PTSD ranged between 16 to 24% prior to the start of the pandemic. American Indians living in rural and tribal communities often experience significant barriers to accessing quality mental health treatment. For these reasons, telepsychiatry is a necessary tool to increase access to care. An entirely home based telepsychiatry program was developed and adapted for PTSD patients within a tribal community and implemented over 12 weeks. 40 patients were engaged at the initiation of the program and a total of 37 remained through the entirety of the program. Patient experiences were assessed based on appointment attendance, the administration of the PCL-5 pre and post program implementation, and patient and staff program evaluations. During the 12 weeks of this program, there was a 4% decrease in patient no shows and rescheduled appointments increased by 23%. Of the 37 patients that completed the program through the 12 weeks, 43% expressed a reduction in PTSD symptoms, 49% saw no change and 8% reported a worsening in PTSD symptoms. Telepsychiatry is a quality treatment delivery method that improves health equity for disadvantaged populations. while also reducing barriers to treatment. Telepsychiatry is comparable to traditional in-person treatment when comparing patient attendance as well as program evaluations. Clinical policies need to address how telepsychiatry can be integrated with in-person care to ensure patients are afforded various options of quality care.
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