Original article
Telepsychiatry with incarcerated youth

https://doi.org/10.1016/j.jadohealth.2005.07.015Get rights and content

Abstract

Purpose

Incarcerated adolescents have a high prevalence of psychiatric disorders but lack psychiatrists to provide ongoing care. Telepsychiatry may provide one solution to treating this underserved population.

Methods

Interactive video conferencing was used to connect a minimum security correctional facility with a regional telemedicine program. Clinical records were reviewed to examine utilization, demographics, diagnoses, pharmacotherapy, and patient satisfaction.

Results

During the 29-month study period, 115 youth were treated using 275 telepsychiatry visits. Substance-use, behavioral, and emotional disorders were highly prevalent. Eighty percent (80%) of the youth were successfully prescribed medications. Youth expressed confidence with the psychiatrist’s recommendations but expressed concerns about privacy.

Conclusions

Telepsychiatry can successfully deliver services to incarcerated adolescents with a wide range of psychiatric needs. A patient-centered approach that directly assesses adolescents’ satisfaction is recommended to ensure youths’ optimal involvement in needed services.

Section snippets

Correctional program and subjects

Naselle Youth Camp (NYC) is a minimum-security juvenile correctional facility in rural Washington state, approximately 200 miles (a four-hour drive) from Seattle. Common offenses include theft, burglary, car theft, harassment, assault, and sex offenses. Less common offenses include rape, drug offenses, vehicular manslaughter, and murder. The average sentence is six months, ranging from 30 days to four years.

NYC partners with the Department of Natural Resources (DNR), the Department of Fish &

Data Analyses

Utilization, diagnoses, and prescribed medications were examined according to gender and age. Mean satisfaction ratings were calculated. Additionally, percentages were calculated for youth rating each item on technical aspects as “very good,” “outstanding,” or “very good or outstanding”; and percentages were calculated for youth rating each item on clinical aspects as “somewhat agree,” “strongly agree,” or “somewhat or strongly agree.” Data are presented without statistical comparisons as no

Results

Few of the youth (6%) did not have previously diagnosed disorders. Those seven youth without prior diagnoses were well distributed over the four groups. According to NYC’s Mental Health Coordinator, no youth refused services and our sample appears representative of youths who needed psychiatric care.

Figure 1 shows the quarterly utilization of the telepsychiatry service. For 24 months the census was steady, representing the quick saturation of the available time slots. The dip in the

Discussion

This descriptive study provides preliminary evidence that telepsychiatry can be used to deliver services at a distance to incarcerated adolescents with a range of psychopathology. Our psychiatrist found that telepsychiatry provided adequate technical resolution and interpersonal rapport to diagnose and treat seriously impaired youth. Anecdotally, in 2005 the model changed. The psychiatrist provided telepsychiatric care and onsite visits during alternate weeks. Diagnoses made through

Conclusions

Based on this experience, future research on the use of telepsychiatry with incarcerated youth seems warranted. This demonstration of the feasibility of establishing a telepsychiatry service, its solid acceptability to youth, and tolerability by staff opens the door for further investigation of the ability of telepsychiatry to deliver evidence-based, quality care that improves outcomes for high-risk incarcerated youth.

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