A narrative systematic review of access and reimbursement policies and practices in telemental health for rural elderly populations

Telemedicine has established its place in supporting the health care needs of individuals who desire to age in place.  Technological advances allowed telemedicine to extend the reach and scope of health care services in rural areas which is an important development for rural elderly residents who are more likely to own their own homes and to age in place. An area of telemedicine that is proving to be particularly promising to rural residents is telemental health. Lack of available transportation, access to local mental health providers, and the increasing potential for health conditions which can precipitate mental and behavioral health concerns; are some of the factors that merit an examination of policies and practices that support the use and expansion of telemental health for rural seniors who are aging in place.

This paper will provide the results of a narrative systematic review of the published literature on critical areas that support or limit the expansion of telemental health for the rural elderly residing in the community. The narrative systematic review focuses on two general areas: access and financing  (reimbursement) of telelmental health services for rural elderly residents.  Searches were conducted using the following databases: Medline, CINHAL, Cochrane and PsychInfo, Sociological Abstracts, and internet search engines (Google/Google Scholar). The overall objectives of this narrative systematic review are twofold: (1) to add to our knowledge base concerning  telemental health’s success in addressing mental health access issues for rural elderly populations, and (2) to identify financing and reimbursement policies and practices for in-home telemental services that support the expansion of in-home telelmental health services for rural elderly populations.