VA's Telehealth Program for Bipolar Disorders Is Associated with Improved Symptoms, Suicide Risk, Quality of Life, and Prescription Quality
BACKGROUND:
Telemental health via videoconferencing can improve access to mental healthcare by connecting providers nationwide with patients in remote locations. Initial, limited analyses of VA’s Bipolar Disorders Telehealth (BDTH) Program — which provides expert mental health consultation and treatment to Veterans with known or suspected bipolar spectrum disorders — suggested that participants had improved quality of care and clinical outcomes. Using significantly more participants and medical centers, this study examined VA clinical, administrative, and survey data to evaluate outcomes (including symptoms, mood episodes, positive suicide screens, and mental health-related quality of life) for Veterans who were referred to the BDTH program from 2011 to 2021. Researchers also investigated adherence to prescription recommendations regarding lithium, antidepressants, and prazosin, and assessed mental health hospitalizations in the year before BDTH referral and the year following referral. Of the 3,026 Veterans who were referred to the BDTH program, 2,456 (average age 46, 87% White, 21% female) had an intake with a BDTH clinician.
FINDINGS:
- Veterans who completed the BDTH program reported reductions in manic (17%) and depressive (29%) symptoms, and a reduction in mood episodes (21%) between their initial assessment and one month after completing the program.
- Veterans demonstrated significant improvements in mental health-related quality of life as well as increased lithium and prazosin (for those with a PTSD diagnosis) prescriptions, along with a 54% reduction in positive suicide screens.
- There was also a significant decrease in mental health hospitalizations, although Veterans who were referred for BDTH services but did not complete a consult saw a similar drop in rates.
IMPLICATIONS:
- Findings from this 10-year evaluation provide further support for the general effectiveness and safety of telemental health via videoconferencing.
LIMITATIONS:
- The data are derived from medical records; confounding variables cannot be ruled out.
AUTHOR/FUNDING INFORMATION:
This study was partially funded by QUERI, with several co-authors funded by the Behavioral Health QUERI Program. Dr. Miller and Ms. Stolzmann are with HSR’s Center for Healthcare Optimization and Implementation Research (CHOIR).
Stein NR, Stolzmann KL, Abel EA, et al., and Miller CJ. Ten Years of Bipolar Telehealth: Program Evaluation of a Team-Based Telemental Health Clinic. Telemedicine and E-Health. October 18, 2024; online ahead of print.
