Home-Based Telepsychiatry in US Urban Area

elepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if thepatient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized forschizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practicewith social worker traveling to the home with electronic tablet for connection with psychiatrist). The intervention resulted indetecting unrecognized depression and complex trauma. The treatment plan included adding an antidepressant and therapy plan,eliminating one psychiatric medication, and reducing dosage of pain medication. The outcomes were improved function and qualityof life. The patient and caregiver were both highly satisfied with the services. This hybrid telepsychiatry is a reasonable option forhomebound elderly patients living in urban areas and less expensive than nursing home admission