TY  - CHAP
M1  - Book, Section
TI  - Telepsychiatry
A1  - Waugh, Maryann
A1  - Yellowlees, Peter
A1  - Dixon, Rachel
A1  - Shore, Jay H.
A2  - Rheuban, Karen Schulder
A2  - Krupinski, Elizabeth A.
Y1  - 1
N1  - 
T2  - Understanding Telehealth
AB  - A  psychiatrist  is  providing  a  weekly  telepsychiatry  clinic  for  a  small  rural  community  mental  health  center  in  the  intermountain  west.  She  evaluates  a  new  patient,  John  a  74-year  old  recently  widowed  rancher  whose  children  have  brought  him  out  of  their  concern  of  his  increasing  isolation.  John  reports  that  since  his  wife  passed  three  months  ago  he  has  been  having  difficulty  sleeping,  leading  to  increasing  fatigued  during  the  day.  He  has  lost  his  appetite  and  motivation  to  engage  in  ranch  work  or  socialize  with  others.  Although  he  denies  current  or  history  of  suicidality,  he  feels  that  he  has  no  reason  to  go  on  living  and  has  access  to  firearms  at  home.  The  psychiatrist  works  with  the  clinic's  onsite  social  worker  to  develop  a  treatment  plan,  which  includes  an  antidepressant  and  sleep  medication  along  with  grief-focused  supportive  therapy.  The  psychiatrist  educates  John  and  his  adult  children  about  depression  and  loss  and  engages  in  a  candid  discussion  about  firearm  safety  in  the  context  of  a  depressive  episode  and  risks  for  suicide.  The  family  agrees  until  the  depression  has  resolved  to  hold  John's  firearms  for  him.  Over  the  next  8  to  12  weeks  through  medication  management  and  therapy  John's  depression  begins  to  resolve,  with  the  psychiatrist  following  John's  progress  in  their  follow-up  video  sessions  and  through  contact  with  the  clinic's  social  worker.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1158358866
ER  -