An Experimental Comparison of Telepsychiatry and Conventional Psychiatry for Mentally Ill Parolees

This study will examine the effectiveness of telecommunications psychiatry (Telepsychiatry). Telepsychiatry refers to the application of telecommunications and computerized information technology as an alternative to face-to-face interactions between the psychiatrist and patients. The project utilizes random assignment to compare traditional psychiatry (i.e., face-to-face sessions) and telepsychiatry for mentally ill parolees with regard to satisfaction with the collaborative bond between therapist and patient, medication adherence, session attendance, psychological functioning and recidivism. In addition, the project will include a cost-effectiveness analysis to assess potential cost savings associated with the use of telepsychiatry with mentally ill parolees returning to rural or remote areas of the state. Surveys of 800 newly admitted patients (400 tele and 400 face to face) and a sample of 15 psychiatrists will measure subjective and objective differences in the two approaches to the delivery of psychiatric services. Outcome measures include short term variables such as consistent use of medication and missed appointments as well as long term recidivism measures. Recidivism measures will include technical violations, arrests, returns to custody and the number of days in custody. Parolees will be interviewed one week prior to admission to a parole outpatient clinic, and six months following randomization. The recidivism follow-up will be captured 12 months following randomization. The study uses existing scales for outcome measures that have established reliability. ca/ncf