Presentation given by Giannis Kakoulas, Klimaka, Greece, at a FEANTSA conference on "The Right to Health is a Human Right: Ensuring Access to Health for People who are Homeless", 2006

1. Applications of telepsychiatry and
evaluation of the programme by the
patients
Vlantoni, D., Kotsyfi, M., Papastefanou, Y., Toumpa, P., Katsadoros, K.
HELLENIC REPUBLIC EUROPEAN COMISSION
MINISTRY OF HEALTH EUROPEAN SOCIAL FUND
AND SOCIAL SOLIDARITY
PROJECT CO-FUNDED WITHIN THE FRAMEWORK OF THE O. P.
“HEALTH & WELFARE” 2000 – 2006

2. Telepsychiatry
Telepsychiatry is a composite term for mental
health related activities, services and systems,
carried out over a distance by means of
information and communications technologies for
the purposes of mental health promotion,
therapeutic interventions as well as education,
management and research for mental health.

3. Telepsychiatry applications
Video – conferencing
Electronic psychiatric file
(in cooperation with CCS S.A.)
Authorized electronic signature for the issuing
of psychiatric reports

4. Services provided via teleconference
Assessment and diagnosis of cases
Therapeutic sessions
Prescription of medication
Staff training and other health professionals
training
Medical center doctor support in cases of
emergency (e.g. suicide attempt )
Staff supervision
Prevention campaigns and health promotion
seminars for parents and students

5. Advantages of telepsychiatry
Health services provision on local level
Minimization of unnecessary long distance travel for
the patient
Direct communication with doctors and health staff in
remote areas for support, information and ideas
exchange, crisis management
Modernization of the work environment with the use
of state-of-the-art technology – familiarization of the
staff with the use of advantaged technology

6. Covered areas by telepsychiatry
Naxos
Santorini For the whole geographical
Ios area of the Cyclades there is
Amorgos
no psychiatrist either in a
public hospital nor in
Folegandros
private practice.
Anafi
Thirasia
Donousa
We provide services to
patients in rural settings
Schinousa
with limited access to
Irakleia health care.
Koufonisi

7. Cost of the telepsychiatry method
Telepsychiatry programs can be less
expensive for patients, reducing travel time,
travel costs and time off from work.
In comparison with the recruitment of a
psychiatrist and the cover of the travel
expenses around the islands, the cost for a
one year period is lower

8. Cost of the telepsychiatry method
As the system has been installed in the islands
medical centers, its combined use with other
telemedicine activities could reduce monthly
telecommunications costs.
telepsychiatry is a
cost-effective method.

9. Illustration of cases
During the 2 year existence of the mobile unit
we have received about 1500 clients.
Most frequent diagnosis:
Psychosis
Depression disorder
Neurosis
Substance dependence (mainly alcohol abuse)

10. Reasons for visiting the
Mental Health Mobile Unit
Psychiatric disorder, counseling, therapeutic
sessions: 61%
Attestations for mental health: 20,7%
Accompanying persons with psychiatric
disorders without a clear request: 14%

11. Telepsychiatry evaluation:
a pilot study
We delivered a short questionnaire to our
clients asking them to evaluate the services
provided and to report their level of
satisfaction.
AIM:to provide quality mental health services;
to improve the telepsychiatry system

12. Sample description (N=82)
Age: mean 46,3 years (s.d.:15,6)
Sex: 42% men, 58% women
Education:
primary school: 53
high school: 35%,
university graduates: 5%
First time in a remote session:
Yes, first time: 61%
No, many times: 39%

13. q.1-3
Technical characteristics of the system
Duration of the session: almost all the
respondents reported that the duration of the
session was satisfactory.
Quality of sound and image during the
videoconference: about 80% of the
respondents appeared to be satisfied with the
equipment and setting.

14. q.4
Contact with the psychiatrist
Concerns were expressed by a low percentage
(18%) for the impersonal nature of contact in
telepsychiatry, while most of the patients
(82%) found the contact with their doctor “as
not at all cold or impersonal”.

15. q.6
level of trust towards the
diagnosis
and/or the medication given
Most of the patients (79%) reported that they
have no doubt for the diagnosis and the
medication given, while only 21% said that
they had a slight doubt

16. q.7
level of trust for the protection of
privacy
85% of our patients reported that they have
no doubt about the protection of their privacy
and confidentiality in a telepsychiatric
session.

17. q.8
choice between a face to face session with a
general doctor or a remote session with a
psychiatrist
Two thirds of respondents (63%) were willing
to participate in psychiatric treatment
delivered via videoconferencing equipment
whether a low percentage (18%) would prefer
to consult a general doctor in a face-to-face
session for a psychological/ psychiatric
disorder.

18. q.9
Overall satisfaction of the patients - I
Patients reported to feel rather comfortably during the
remote session.
60 56
50
40 37,3
not comfortably
neither
30
comfortably
20 very comfortably
10 7,5
5
0

19. q.9
Overall satisfaction of the patients - II
Patients reported high satisfaction with and
acceptance of the use of remote technology for
treatment and assessment.
60 55,6
50
40 38,3
not satisfied
30 neither
satisfied
20 very satisfied
10
3,7 2,5
0

20. q.9
Overall satisfaction of the patients - III
Rating of the telepsychiatry system by the patients:
70 60,5
60
50 39,5
40 almost good
30 good
20
10
0

21. Conclusions
Telepsychiatry is an innovative method for
the Greek Mental Health System which
allows the provision of mental health services
in rural and underserved populations.
The results of our study provide preliminary
support for the telepsychiatry system, but
further research has to be made.

22. References
BROODEY, B., B., et al. (2000) Satisfaction of forensic psychiatric patients with
remote telepsychiatric evaluation, Psychiatric Services, 51, 10.
FRUEH, B., C., et al. (2000) Procedural and methodological issues in telepsychiatry
research and program developing, Psychiatric Services, 51, 12.
MONNIER, J., KNAPP, R., G., FRUEH, B., C., (2003) Recent advances in
telepsychiatry: an updated review, Psychiatric Services, 54, 12.
KENNEDY, Craig (1999) Clinical Practical Guidelines for Using Videoconferencing
Technology in Queensland Mental health Services, Queensland Telemedicine
Network.
ROHLAND, B., M., et al.(2000) Acceptability of telepsychiatry to a rural population,
Psychiatric Services, 51, 5.
WHO (1998), A Health Telematics Policy, Report of the WHO Group Consultation on
Health Telematics 11-16 December, Geneva, 1997
ΚΑΡΑΓΙΑΝΝΗΣ Χ. (2004), εταιρεία ιατρικών οργάνων υψηλής τεχνολογίας και
συστημάτων τηλεϊατρικής, Παρουσίαση των συστημάτων τηλεϊατρικής.

23. Thank you very much for your
presence and for your attention!
Miss Diamanto Vlantoni,
Social Psychologist
diamavlantoni@msn.com