For Native Americans living in tribal communities, the closest mental health care professional can be hours away – if one is available at all. Yet years of intergenerational trauma, high rates of mental illness and substance abuse mean these residents often have a significant need for these services. As a result, a growing number of tribal communities are turning to telepsychiatry for access to high-quality, culturally-sensitive mental health care clinicians for the people that call these communities home.

In our latest Sector Spotlight, we share insights on telepsychiatry in Native American communities from Regroup’s recent appearance on “American Indian Living.” During the podcast, Naveen Kathuria, Regroup’s senior vice president, partnerships and compliance, explains how telepsychiatry is helping these communities access highly specialized clinicians equipped to serve their population’s unique needs.

Why is it challenging for tribal communities to provide mental health care?

More than 4 million Americans identify as Native Americans or Alaskan Natives, with roughly one-third of them living on reservations. For many of these Americans, a history of trauma, poverty and other factors combine to create deeply rooted mental health issues. Compared with the rest of the U.S. population, Native Americans experience mental illness 1.5 times as often as the rest of the U.S. population, and are also three times more likely to experience co-occurring mental illness and substance abuse.

But while the need is great, rates of mental health utilization are low among Native Americans. Many tribal communities struggle to recruit and retain mental health clinicians, particularly those who can meet this population’s significant clinical and cultural needs. In addition to specializing in children and adolescents as well as addiction therapy, clinicians with experience treating intergenerational trauma are extremely valuable to these patient populations. They must then be able to integrate care into the community’s overall approach, which may include traditional healing or other holistic methods.

How does telepsychiatry help these communities deliver more effective care?

In his interview with “American Indian Living,” Kathuria outlined how telepsychiatry can help tribal populations access much-needed care more effectively. Key benefits include:

- Virtually unlimited access to high-quality clinicians. Telepsychiatry allows communities to connect with clinicians from anywhere, opening up a universe of clinicians with specialized expertise. Depending on their needs, tribal health clinics can source professionals skilled in treating substance abuse, children and adolescents, and integrating behavioral health into culturally appropriate care. “You can draw from a larger geographical scope, which is really something that resonates when we’re working with reservations,” Kathuria says. “Clinics also don’t have to worry that their clinician is going to leave because they’re not a fit with the community.”

- Shorter wait times for treatment. Many tribal communities offer telepsychiatry directly through their primary care clinics on the reservation, meaning patients no longer have to travel long distances or wait months for an appointment. This approach can also help patients overcome worries about receiving mental health services by erasing the stigma of traveling to a specialist’s office for treatment. “Developing trust with your provider is key,” Kathuria says. “Patients already have that trust established with their primary care provider, so if you can integrate telepsychiatry into that setting, it becomes a lot more effective.”

- Right-sized services. Smaller tribal clinics may only need one day of mental health services per week yet are forced to commit to a full-time professional. Telepsychiatry allows these communities to tailor services by offering the flexibility to easily scale up or down based on population size and patient needs.

Getting telepsych right in Native American communities

- Find the right clinician. When searching for your perfect match, look for a clinician who specializes in your patients’ needs and is trained specifically in providing telemedicine so they can engage the patient effectively. Continuity of care is also critical, so make sure you’ll be working with the same clinician weekly if you source one through an external telepsychiatry company. “You want patient to feel comfortable, so they can get into issues they’re facing,” Kathuria says. “That’s not possible if you’re seeing someone different every week.”

- Integrate telepsychiatry around your existing practices, not the other way around. For time- and resource-strapped tribal clinics, your teleclinician should integrate into your existing processes to keep the transition as simple as possible and ensure a collaborative care approach. That includes charting in your clinic’s electronic health record, participating in regular check-ins with on-site clinicians and adapting to the clinic’s care delivery model. For example, with substance abuse widespread in certain communities, some tribal clinics ask teleclinicians to avoid prescribing controlled substances whenever possible.

- Stay informed on current regulations and impending changes. Since the U.S. declared a state of emergency on the opioid crisis, the government has been loosening guidelines around delivering care via telemedicine to help more people access treatment. As regulations and laws around prescribing, patient-provider relationships and reimbursement evolve, it’s important to monitor them closely in order to remain in compliance. An external telepsychiatry partner can help manage this process.

Contact us to learn more about implementing telepsychiatry programs in Native American communities. You can also listen to Naveen Kathuria's full interview on the "American Indian Living" podcast.

LISTEN TO THE PODCAST