Telepsychiatry allows patients to receive psychiatric care through audio or video calls, making it easier for those with mental health issues to get the help they need. I’ve been an early supporter of using telepsychiatry to treat patients and have seen how valuable it is, especially for people in rural areas. The path to where telepsychiatry is now has been challenging, with many rules and obstacles along the way, but it’s clear that telepsychiatry is here to stay because patients want it.
In 2006, Pennsylvania began offering telepsychiatry services to help people in rural areas access mental health care. I was one of the first psychiatrists to provide this service. In 2007, I helped a hospital system set up telepsychiatry between emergency rooms, allowing doctors to evaluate psychiatric patients who were waiting for a bed in a psychiatric facility. This service is still running today and was even recognized as a successful example by the American Hospital Association.
In 2009, telepsychiatry expanded when Medicare started reimbursing psychiatrists for telehealth services to people living in underserved areas. This was a big step forward. However, there were some legal challenges as well. In 2008, a law was passed that banned prescribing controlled substances over the internet, but the rules for enforcing this law have still not been fully implemented, even though they were supposed to be in place by now.
From 2012 to 2020, telepsychiatry grew rapidly, especially as the country faced a growing mental health crisis and a shortage of psychiatrists. By 2020, more adults were reporting mental health issues, and telepsychiatry became a mainstream service, especially during the COVID-19 pandemic. Sadly, many areas still don’t have enough psychiatrists, and only 30% of people live in places where they can easily access mental health care.
Telepsychiatry has proven to be just as effective as in-person care, and patients in rural areas have benefited greatly from it. During the pandemic, telephonic appointments (using just audio) were allowed for patients without internet access. However, this flexibility will end in 2024, which means that many rural patients will have to travel to see a psychiatrist in person, making care more difficult to access.
Unfortunately, telepsychiatry has faced legal challenges. In 2022, I was accused of healthcare fraud for services I provided in 2017, but I was found not guilty in 2024. During the trial, it was clear that the government did not fully understand telepsychiatry or its rules. Many other doctors and telepsychiatry companies have also faced legal issues, even though telepsychiatry is a proven and effective way to deliver care.
The COVID-19 pandemic has shown how valuable telepsychiatry is and how much patients appreciate it. Many psychiatrists continue to use it because it’s convenient and effective, and patients prefer it for the privacy and ease it provides. There’s hope that regulatory agencies will realize this and extend the current flexibility, allowing telepsychiatry to continue as a key service in mental health care.
Dr. Muhamad Aly Rifai is a practicing psychiatrist and internist based in the Greater Lehigh Valley, Pennsylvania. He is the CEO of Blue Mountain Psychiatry and holds the Lehigh Valley Endowed Chair of Addiction Medicine. He is board-certified in internal medicine, psychiatry, addiction medicine, and psychosomatic medicine.