Barriers to using telemedicine for preventing mental illness in rural Maine

Telemedicine has been established as an effective tool to improve rural health care including improving mental health. Using the principles of Community Based Participatory Research (CBPR) we conducted a community health assessment to examine the primary health care needs among residents of rural Washington County in Maine. The preliminary data indicate that although Washington County was one of the pioneers in introducing telemedicine in primary care, there are significant barriers to providing telemedicine-based mental health services in this rural county, where mental illness including substance abuse is one the primary health concerns in the community. These barriers include maintenance cost of infrastructure; provider reimbursement issues; licensing issues in satellite establishments; concerns of privacy on both ends of interaction; lack of psychiatrists trained in telemedicine; lack of training among providers; lack of virtual technology skills among general population; and shortage of practitioners. The presentation provides detailed accounts of prevaling t mental health issues among the residents and the psycho-social and structural barriers to providing telemedicine-based mental health prevention.