Telemedicine solutions: the pros and cons

Phone applications and online programs mimicking traditional psycholigical treatments are being trialled across Denmark. Yet for each problem they fix, another is born.

By Lucy Hinton and Emma Rose Haas, 12 December 2014

Screen Shot 2014-12-11 at 17.55.04
Kit Lisbeth Jensen is able to treat patients from Denmark, Norway, Greenland and the Faroe Islands

Skagen is the most Northern city in Denmark. The transportation possibilities are limited and the city’s population is little more than 8000 people. To reach this uppermost tip of Denmark people must drive, or train, or bus for hours. It therefore seems like an unlikely place for someone suffering depression in Copenhagen, to see a psychologist.

But Kit Lisbeth Jensen, a private psychologist in Skagen, treats, counsels, and gives advice to many patients each day. Kit is the founder of the website, an Internet based psychology solution where patients can chat and receive professional advice online, from their homes far away from Skagen. They are only required to submit a name, telephone number, email address and emergency contact, before Kit’s treatment begins.

The pros to online psychology treatment are many. It reduces the time patients spend travelling to and from their psychologist, it is cheaper, and it does not require a doctor’s referral. Jensen says the privacy of the treatment and the fact that the patient can remain at home, also makes it an attractive option. She says these reasons alone are enough to reduce the amount of people on waiting lists for treatment, and encourage people to seek help earlier.

READ MORE: Tele-psychiatry shakes up Danish welfare system

Online treatment not appropriate for severe cases

A problem with web based psychology help is the limited amount of eligible patients. Patients with severe depressions, who endanger themselves and their surroundings, would not benefit from the online help, says Jensen. In fact, Jensen fears that this kind of treatment, if given to the wrong person, may actually escalate the problem. Face to face therapy remains the best treatment for these more severe cases.

However, the possible use of telemedicine to treat high-risk patients is currently being explored at the Department for Depression and Anxiety in the Aarhus University Hospital. Christian Møller Pedersen, head psychologist of this department, who specialises in suicide prevention, is working on a mobile phone app that may help psychologists treat suicidal patients.

“We do not think the app can stand alone or that it can help people without having on going psychotherapy at the same time. So the app is not functioning by itself, its app-assisted therapy,” says Pedersen.

READ MORE: Southern Denmark’s online psychology trial has no face-to-face contact

Psychologists need proper guidelines for web based treatment

Jensen agrees that the face-to-face contact is essential, particularly when patients are hit with big crisis.

“When treating patients online how can the psychologist read the body language? How can they evaluate that when they say “bye” the patient will not log off and commit suicide? Click! And the patient is gone,” she says.

Jensen’s online office is not an intimidating place for patients to visit.

Jensen has the advantage of a safe web based system where she can find the patient’s information and send someone nearby to check up on the person, in case of an immediate emergency. Yet she believes there should be more concrete national guidelines in place for online psychologists.

“We have to have a plan in case of a crisis, in case something goes wrong. How can we take care of our clients in cyberspace if we don’t know what to do? We have to be prepared,” she says.

The Ethics Board at the Danish Psychologist Union is currently looking into the possible problems of psychologists treating patients online, and trying to create a framework for them to operate within.