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Telehealth for Rural Diverse Populations: Cultural and Telebehavioral Competencies and Practical Approaches for Clinical Services

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Abstract

Rural health care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health disorders. Telepsychiatry and telebehavioral health improve access to care and leverage scarce resources like specialty expertise and language interpreters. This paper focuses on the three questions, particularly related to medical settings: (1) What are the components of culturally competency clinical care and what fundamental approaches help providers? (2) What fundamental approaches like the cultural formulation interview and the bio-psycho-socio-cultural model help providers achieve it? (3) How do we link outcomes with culturally competent and telepsychiatric competencies? Rural underserved patients need culturally competent care, which requires skills by all health care team members. Skill-focused training based on practical everyday practices, cases, and pedagogic methods can improve care and engage participants. Telepsychiatric care is similar to in-person care, either requires integrated cultural and telepsychiatric skills. Educational and administrative adjustments are needed to promote culturally competent care, particularly by telehealth. Rural populations need culturally competent care and teams with telepsychiatric skill sets increase access. More quantitative and qualitative research is suggested to improve the approach and better evaluate, administer, and finance services.

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Acknowledgements

American Association of Directors of Psychiatry Residency Training, Coalition for Technology in Behavioral Science (CTIBS), Telebehavioral Behavioral Health Institute (TBHI), and UC Davis School of Medicine and Department of Psychiatry and Behavioral Sciences were acknowledged, including Drs. Francis Lu, Russell Lim, and Hendry Ton.

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Authors and Affiliations

  1. Mental Health, Northern California Veterans Administration Health Care System, Sacramento, CA, USA

    Donald M. Hilty

  2. Department of Psychiatry and Behavioral Sciences, UC Davis, Davis, CA, USA

    Donald M. Hilty

  3. Psychiatry and Addiction Medicine, Kaweah Delta Medical Center, Visalia, CA, USA

    Gregory Evangelatos, Christine Le & Juan Sosa

  4. Medical Student, American University of Antigua College of Medicine, New York, NY, USA

    G. Andrew Valasquez

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Hilty, D.M., Evangelatos, G., Valasquez, G.A. et al. Telehealth for Rural Diverse Populations: Cultural and Telebehavioral Competencies and Practical Approaches for Clinical Services. J. technol. behav. sci. 3, 206–220 (2018). https://doi.org/10.1007/s41347-018-0054-6

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