A child and adolescent psychiatric outreach service for rural New South Wales: a telemedicine pilot study.

Objective: To examine the feasibility of a tertiary outreach service in child and adolescent psychiatry to two rural health centres in New South Wales, Australia. Methods: Following a site visit to Dubbo Hospital and Bourke Hospital, telemedical videoconferencing was provided for 2 h/week for 32 weeks. Details of referrers, patients’ diagnosis and outcome, and satisfaction with the service were obtained. Results: Cases were triaged by a nominated rural adolescent mental health worker. The service provided detailed assessment and management of severe, complex, mental and neuropsychiatric disorders. Fifty-four young people were assessed and 72 joint consultative videoconferencing interviews were undertaken, including 26 initial consultations. Twenty-three initial consultations were undertaken on the visit to the rural centres. Clinical descriptions illustrate the flexibility and sensitivity of the service. Conclusion: Telepsychiatry provides access to a flexible, effective tertiary service for those with special, complex needs, including the disadvantaged or isolated. It makes a valuable, economic contribution to supporting and educating rural health professionals, thereby enriching rural mental health services.