After the heart-wrenching, high-profile suicide of Austin “Gus” Deeds in November, Virginia’s psychiatric services have received national attention and critique.
Virginia, like many other states across the country, struggles with a shortage of psychiatrists. U.S. News reports that for Virginia’s population of over 8 million residents, there are only 1051 psychiatrists practicing within Virginia. Virginia also faces a shortage of inpatient psychiatric beds, just 22.5 beds per 100,000 residents, which is below the national average.
In addition to having little availability for individuals who need to be admitted, a report released by the Office of the State Inspector General claims Virginia has done a poor job managing psychiatric programs designed to safely return individuals who have been hospitalized to the community. 
In response to these pain points, several mental health reform packages have been introduced in Virginia — many of them led by Senator Creigh Deeds, the father of Austin.
One reform proposes an extension on the amount of time mental health workers have to find a bed for someone in crisis, another hopes to establish an online registry of available psychiatric beds within the state and the last would require state facilities to provider “beds of last resort” for those who require care.
While I commend Virginia and Senator Deeds on these steps to improve the psychiatric options within Virginia, there is one avenue that has not been seriously considered that could alleviate many of these psychiatric woes — telepsychiatry.
Telepsychiatry is psychiatric care provided over videoconferencing platforms. It is proven as an effective form of care and has a number of different applications that could be utilized across the spectrum within Virginia.
Additionally, telepsychiatry is an excellent way to increase access to Virginia-licensed providers who may live in other parts of the country, and a tool for leveraging the time of existing Virginia-based providers who could seamlessly transition between appointments at different locations without having to physically travel.
Telepsychiatry could be used to improve the psychiatric services in Virginia in several ways:
1) For inpatient units or psychiatric hospitals: Virginia could use telepsychiatry within inpatient units or psychiatric hospitals to increase their psychiatric capacity and more quickly and appropriately treat individuals struggling with their mental health.
2) For hospital emergency departments: By incorporating 24-hour on-demand telepsychiatry programs, hospitals could have timely access to psychiatric providers for commitment and treatment decisions. This would help to alleviate psychiatric boarding and shorten wait times for all emergency department patients.
3) For community-based facilities: Other settings that could benefit from improved access to psychiatric providers include correctional facilities, outpatient facilities, universities, primary care offices, urgent care centers and FQHCs. By increasing the psychiatric capacity of community-based programs it is less likely for a person to reach psychiatric crisis that requires hospitalization.
4) For follow-up care: It is important for an individual to continue to receive treatment and care after they have suffered from a psychiatric episode. Unfortunately, timely access to a psychiatrist is extremely difficult, particularly in rural or underserved areas. Telepsychiatry represents unprecedented access to care.
Telepsychiatry is not a new concept and states across the nation are gradually adopting it as a solution to their own psychiatric challenges. I urge Virginia to consider this effective medium of care as they make improvements to Virginia’s behavioral health services.
Dr. Jim Varrell
James R. Varrell, M.D. is American Board certified in Psychiatry and Neurology, and certified in American Academy of Child and Adolescent Psychiatry with a specialty in autism. Dr. Varrell has been at the forefront of telepsychiatry across the nation and continues to educate the medical community regarding the benefits of telepsychiatry through various presentations and forums where he has served as a panelist and presenter. Dr. Varrell preformed the nation’s first involuntary psychiatric commitment via a televideo unit in 1999. Today, Dr. Varrell still regularly performs telepsychiatry evaluations and manages a staff of telepsychiatrists who see and treat patients in 16 states.
 American Academy of Emergency Physicians 2013 Report Cards