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Only about 40 percent of the 60 million people in the United States with a mental health problem receive any care at all, and only about 33 percent of that group receive what the field considers to be minimally acceptable care, said National Institute on Mental Health program officer Adam Haim, PhD, at APA's 2011 Annual Convention.

To bridge that gap, NIMH is funding researchers who are developing ways to use modern communication technology, such as personal digital assistants, cellphones and the Web, to reach more people, he said.

"Clearly there is a need for interventions for individuals who are being underserved or receiving no services at all," said Haim.

Most of NIMH's IT-enhanced grants are developing interventions that harness personal computers, and about 60 percent use the Web, he said. However, "we are seeing a shift toward mobile devices, and that shift is going to happen quickly," Haim said. Within NIMH, the biggest funders of IT-enhanced research are the Division of Services and Intervention Research and the Division of AIDS Research, he said. And while most IT enhanced grants are large-scale research grants, known as R01s, the agency is increasingly using R44 and R43 grants to fund small businesses' efforts to develop technology, Haim said.

Most of NIMH's IT-enhanced intervention based research uses technology as an adjunct to traditional in-person, one-on-one therapy. However, the agency is interested in research that explores ways to reach multiple people simultaneously, Haim said.

"We want to have and fund the grants that are really pushing the envelope, we want to rapidly test and refine these technologies, and we want rapid uptake of interventions," he said.

Telehealth is clearly a growing practice area, observed session chair Linda Campbell, PhD, but many questions remain unanswered about its ethical and legal implications. To begin to answer those questions, APA and the Association of State and Provincial Psychology Boards have formed a joint task force and begun to collect different groups' comments on the issue, she said.

The legal, regulatory and reimbursement landscape for telepsychology is also in flux, said Deborah C. Baker, JD, director of regulatory affairs for APA's Practice Directorate. Three states—California, Kentucky, and Vermont—have enacted telehealth laws, and several state licensing boards have opined on the issue, she said.

"If you do live in a state that has a state telehealth law, make sure you understand what definition of telehealth they are using, and whether it applies to you," she said.


For more about the current state of telepsychology, visit A new emphasis on telehealth.

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