Telepsychiatry integration of mental health services into rural primary care settings

John C. Fortney, Jeffrey M. Pyne, Eric E. Turner, Kellee M. Farris, Tre M. Normoyle, Marc D. Avery, Donald M. Hilty, Jürgen Unützer

Research output: Contribution to journalArticle

56 Scopus citations


From a population health perspective, the mental health care system in the USA faces two fundamental challenges: (1) a lack of capacity and (2) an inequitable geographic distribution of services. Telepsychiatry can help address the equity problem, and if applied thoughtfully, can also help address the capacity problem. In this paper we describe how telepsychiatry can be used to address the capacity and equity challenges related to the delivery of mental health services in rural areas. Five models of telepsychiatry are described, including (1) the traditional telepsychiatry referral model, (2) The telepsychiatry collaborative care model, (3) the telepsychiatry behavioural health consultant model, (4) the telepsychiatry consultation-liaison model, and (5) the telepsychiatry curbside consultation model. The strong empirical evidence for the telepsychiatry collaborative care model is presented along with two case studies of telepsychiatry consultation in the context of the telepsychiatry collaborative care model. By placing telepsychiatrists and tele-therapists in consultation roles, telepsychiatry collaborative care has the potential to leverage scarce specialist mental health resources to reach more patients, thereby allowing these providers to have a greater population level impact compared to traditional referral models of care. Comparative effectiveness trials are needed to identify which models of telepsychiatry are the most appropriate for patients with complex psychiatric disorders.

Original languageEnglish (US)
Pages (from-to)525-539
Number of pages15
JournalInternational Review of Psychiatry
Issue number6
StatePublished - Nov 2 2015
Externally publishedYes


  • Collaborative care
  • integrated care
  • rural
  • telepsychiatry
  • virtual care

ASJC Scopus subject areas

  • Psychiatry and Mental health

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  • Cite this

    Fortney, J. C., Pyne, J. M., Turner, E. E., Farris, K. M., Normoyle, T. M., Avery, M. D., Hilty, D. M., & Unützer, J. (2015). Telepsychiatry integration of mental health services into rural primary care settings. International Review of Psychiatry, 27(6), 525-539.