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Barb Johnston

Bio: Barb Johnston is an academic researcher from University of California, Davis. The author has contributed to research in topics: Telemedicine & Telepsychiatry. The author has an hindex of 4, co-authored 6 publications receiving 713 citations.

Papers
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Journal ArticleDOI
TL;DR: Telemental health is effective for diagnosis and assessment across many populations and for disorders in many settings and appears to be comparable to in-person care.
Abstract: Introduction: The effectiveness of any new technology is typically measured in order to determine whether it successfully achieves equal or superior objectives over what is currently offered. Research in telemental health—in this article mainly referring to telepsychiatry and psychological services—has advanced rapidly since 2003, and a new effectiveness review is needed. Materials and Methods: The authors reviewed the published literature to synthesize information on what is and what is not effective related to telemental health. Terms for the search included, but were not limited to, telepsychiatry, effectiveness, mental health, e-health, videoconferencing, telemedicine, cost, access, and international. Results: Telemental health is effective for diagnosis and assessment across many populations (adult, child, geriatric, and ethnic) and for disorders in many settings (emergency, home health) and appears to be comparable to in-person care. In addition, this review has identified new models of car...

777 citations

Journal ArticleDOI
TL;DR: No abstract available Keywords: adolescents; children; e-heatlh; practice guidelines; telehealth; telemental health.
Abstract: No abstract available Keywords: adolescents; children; e-heatlh; practice guidelines; telehealth; telemental health

127 citations

Journal ArticleDOI
TL;DR: Overall, telemedicine, cross-training, stepped care roles, and use of clinically “versatile” clinicians help to fill “holes” in services for patients.
Abstract: Contemporary healthcare has a patient-centered approach, integrates health/mental health care, emphasizes interdisciplinary teamwork, and adopts innovations such as communications technology. Telemedicine (including telepsychiatry) adds versatility to service delivery by improving access to care, leveraging expertise of key disciplines to the point-of-service, and tele-education. Key disciplines in integrated care, wherein psychiatric and other mental health services are provided in a primary care platform, are the psychiatrist, other mental health professionals (i.e., psychologists, social workers, marriage and family therapists), mid-level professionals, and nurses. These clinicians provide clinical, administrative, and care coordination expertise or oversight. Overall, telemedicine, cross-training, stepped care roles, and use of clinically “versatile” clinicians help to fill “holes” in services for patients. Evidence-based treatment becomes more accessible, better disseminated, and in “real-time” with use of technology.

6 citations

Book ChapterDOI
01 Jan 2016
TL;DR: Overall, telemedicine, cross-training, stepped care roles, and use of clinically “versatile” clinicians – all of these help to fill “holes” in services for patients.
Abstract: Contemporary health care promotes a patient-centered approach, integrates health/mental health care, emphasizes interdisciplinary teamwork, and adopts innovations such as communications technology. Telemedicine, including e-Mental Health (eMH), e.g., telepsychiatry, adds versatility to service delivery by improving access to care, leveraging expertise of key disciplines to the point-of-service, and disseminating education. Key disciplines in integrated care that provide mental health services into primary care are the psychiatrist, mid-level professionals, and nurses. These clinicians provide clinical, administrative, and care coordination expertise or oversight. A more recent addition to this integrated team is the care navigator who essentially coordinates care across all other team members and the patients. Overall, telemedicine, cross-training, stepped care roles, and use of clinically “versatile” clinicians – all of these help to fill “holes” in services for patients. Evidence-based treatment becomes more accessible, better disseminated, and in “real time” with use of health technologies. Best practices for clinical care, education, and program development are needed for integrated care and e-health.

5 citations


Cited by
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Journal ArticleDOI
TL;DR: A large evidence base supports telepsychiatry as a delivery method for mental health services and that telepsychiatric services are actually more cost-effective in the majority of studies reviewed.
Abstract: AIM: To conduct a review of the telepsychiatry literature. METHODS: We conducted a systematic search of the literature on telepsychiatry using the search terms, “telepsychiatry”, “telemental health”, “telecare”, “telemedicine”, “e-health”, and “videoconferencing”. To meet criteria for inclusion, studies had to: (1) be published in a peer-reviewed journal after the year 2000; (2) be written in English; (3) use videoconferencing technology for the provision of mental health assessment or treatment services; and (4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in PubMed (Medline database), Ovid medline, PsychInfo, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories: (1) satisfaction; (2) reliability; (3) treatment outcomes; (4) implementation outcomes; (5) cost effectiveness; and (6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion. RESULTS: Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of mental health services and that telepsychiatry is actually more cost-effective in the majority of studies reviewed. Notwithstanding legal concerns about loss of confidentiality and limited capacity to respond to psychiatric emergencies, we uncovered no published reports of these adverse events in the use of telepsychiatry. CONCLUSION: A large evidence base supports telepsychiatry as a delivery method for mental health services. Future studies will inform optimal approaches to implementing and sustaining telepsychiatry services.

337 citations

Journal ArticleDOI
TL;DR: The rapid implementation of telemedicine within an adolescent and young adult (AYA) medicine clinic in response to the Coronavirus Disease 2019 (COVID-19) pandemic is described to be feasible and acceptable for clinic patients.

255 citations

Journal ArticleDOI
TL;DR: Suicide rates for adolescents and young adults are higher in rural than in urban communities regardless of the method used, and rural-urban disparities appear to be increasing over time.
Abstract: Importance Little is known about recent trends in rural-urban disparities in youth suicide, particularly sex- and method-specific changes. Documenting the extent of these disparities is critical for the development of policies and programs aimed at eliminating geographic disparities. Objective To examine trends in US suicide mortality for adolescents and young adults across the rural-urban continuum. Design, Setting, and Participants Longitudinal trends in suicide rates by rural and urban areas between January 1, 1996, and December 31, 2010, were analyzed using county-level national mortality data linked to a rural-urban continuum measure that classified all 3141 counties in the United States into distinct groups based on population size and adjacency to metropolitan areas. The population included all suicide decedents aged 10 to 24 years. Main Outcomes and Measures Rates of suicide per 100 000 persons. Results Across the study period, 66 595 youths died by suicide, and rural suicide rates were nearly double those of urban areas for both males (19.93 and 10.31 per 100 000, respectively) and females (4.40 and 2.39 per 100 000, respectively). Even after controlling for a wide array of county-level variables, rural-urban suicide differentials increased over time for males, suggesting widening rural-urban disparities (1996-1998: adjusted incidence rate ratio [IRR], 0.98; 2008-2010: adjusted IRR, 1.19; difference in IRR, P = .02). Firearm suicide rates declined, and the rates of hanging/suffocation for both males and females increased. However, the rates of suicide by firearm (males: 1996-1998, 2.05; and 2008-2010: 2.69 times higher) and hanging/suffocation (males: 1996-1998, 1.24; and 2008-2010: 1.63 times higher) were disproportionately higher in rural areas, and rural-urban differences increased over time ( P = .002 for males; P = .06 for females). Conclusions and Relevance Suicide rates for adolescents and young adults are higher in rural than in urban communities regardless of the method used, and rural-urban disparities appear to be increasing over time. Further research should carefully explore the mechanisms whereby rural residence might increase suicide risk in youth and consider suicide-prevention efforts specific to rural settings.

252 citations

Journal ArticleDOI
TL;DR: Data is provided on psychiatric patients’ prevalence of smartphone ownership, patterns of use, and interest in utilizing mobile applications to monitor their mental health conditions to explore new modalities of monitoring, treatment, and research of psychiatric andmental health conditions.
Abstract: Background: Patient retrospective recollection is a mainstay of assessing symptoms in mental health and psychiatry. However, evidence suggests that these retrospective recollections may not be as accurate as data collection though the experience sampling method (ESM), which captures patient data in “real time” and “real life.” However, the difficulties in practical implementation of ESM data collection have limited its impact in psychiatry and mental health. Smartphones with the capability to run mobile applications may offer a novel method of collecting ESM data that may represent a practical and feasible tool for mental health and psychiatry. Objective: This paper aims to provide data on psychiatric patients’ prevalence of smartphone ownership, patterns of use, and interest in utilizing mobile applications to monitor their mental health conditions. Methods: One hundred psychiatric outpatients at a large urban teaching hospital completed a paper-and-pencil survey regarding smartphone ownership, use, and interest in utilizing mobile applications to monitor their mental health condition. Results: Ninety-seven percent of patients reported owning a phone and 72% reported that their phone was a smartphone. Patients in all age groups indicated greater than 50% interest in using a mobile application on a daily basis to monitor their mental health condition. Conclusions: Smartphone and mobile applications represent a practical opportunity to explore new modalities of monitoring, treatment, and research of psychiatric and mental health conditions. [JMIR Mhealth Uhealth 2014;2(1):e2]

246 citations

Journal ArticleDOI
TL;DR: The findings confirm the feasibility and acceptability of emerging mHealth and eHealth interventions among people with SMI; however, it is not possible to draw conclusions regarding effectiveness.
Abstract: Background: Serious mental illness (SMI) is one of the leading causes of disability worldwide. Emerging mobile health (mHealth) and eHealth interventions may afford opportunities for reaching this at-risk group.Aim: To review the evidence on using emerging mHealth and eHealth technologies among people with SMI.Methods: We searched MEDLINE, PsychINFO, CINAHL, Scopus, Cochrane Central, and Web of Science through July 2014. Only studies which reported outcomes for mHealth or eHealth interventions, defined as remotely delivered using mobile, online, or other devices, targeting people with schizophrenia, schizoaffective disorder, or bipolar disorder, were included.Results: Forty-six studies spanning 12 countries were included. Interventions were grouped into four categories: (1) illness self-management and relapse prevention; (2) promoting adherence to medications and/or treatment; (3) psychoeducation, supporting recovery, and promoting health and wellness; and (4) symptom monitoring. The interventions...

241 citations