Telemental health uses information and telecommunication technologies to deliver mentalhealthcare services in situations where the VHA clinician and the veteran needing mental-health services are separated by geographic distance.

Twelve years ago, telemental health was primarily a tool veterans could use to videoconference with their psychiatrist to prescribe medications from a distance. Veterans would travel to a clinic close to their home and “see” their remote clinician on a video-television screen. The clinician would often be at a main VA healthcare facility. The visit would usually take place in the same way an in-person visit would, except it used real-time video and audio technologies.

During 10 years of research — much of it conducted as pioneering studies in VA — has provided evidence on the safety and effectiveness of telemental health. Consequently, VA’s telemental-health services have expanded, with more than a tenfold increase in veterans receiving telemental-health services. VHA telemental-health services now are used in the following ways:

• To deliver most every type of treatment to veterans, including individual therapies, group therapies, medication management, family therapy, couples therapy, cognitive-behavior therapies, evidence-based psychotherapies and psychological testing;
• To treat most every mental-health diagnosis of veterans, including mood disorders, anxiety disorders, post-traumatic stress disorder, psychotic disorders and substance-use disorders;
• To deliver care by clinicians from multiple VHA mental-health professions and specialties including psychiatrists, psychologists, advanced practice clinical nurse specialists, physician assistants, social workers, RNs, addiction specialists, vocational rehabilitation specialists and trainees;
• To deliver care at multiple VHA sites, including VA medical centers, community-based outpatient clinics, VA residential-care centers, non-VA healthcare facilities, student health centers, homeless shelters, supervised housing sites and patients’ homes; and
• To deliver care through a wide range of VHA technology applications. The majority of telemental health occurs via clinical videoconferencing. This replicates an in-person visit that connects veterans — often physically located at VA clinics or VET Centers — with clinicians at remote VA healthcare sites. Additional technologies expand mental-health treatment into the home, including video, in-home messaging and mobile apps.