The Use of Telepsychiatry Services in Emergency Settings:Scoping Review

Background: Telepsychiatry (TP), a live video meeting, has been implemented in many contexts and settings. It has a distinctadvantage in the psychiatric emergency department (ED) setting, as it expedites expert assessments for psychiatric patients.However, limited knowledge exits for TP's effectiveness in the ED setting, as well as the process of implementing TP in thissetting.Objective: This scoping review aimed to review the existing evidence for the administrative and clinical outcomes for TP inthe ED setting and to identify the barriers and facilitators to implementing TP in this setting.Methods: The scoping review was conducted according to the guidelines for the PRISMA-ScR (Preferred Reporting Items forSystematic Reviews and Meta-Analyses extension for Scoping Reviews). Three electronic databases were examined: PubMed,Embase, and Web of Science. The databases were searched from January 2013 to April 2023 for papers and their bibliography.A total of 2816 potentially relevant papers were retrieved from the initial search. Studies were screened and selected independentlyby 2 authors.Results: A total of 11 articles were included. Ten papers reported on administrative and clinical outcomes of TP use in the EDsetting and 1 on the barriers and facilitators of its implementation. TP is used in urban and rural areas and for settings with andwith no on-site psychiatric services. Evidence shows that TP reduced waiting time for psychiatric evaluation, but in some studies,it was associated with prolonged total length of stay in the ED compared with in-person evaluation. Findings indicate loweradmission rates in patients assessed with TP in the ED. Limited data were reported for TP costs, its use for involuntary commitmentevaluations, and its use for particular subgroups of patients (eg, those with a particular diagnosis). A single paper examined TPimplementation process in the ED, which explored the barriers and facilitators for implementation among patients and staff in arural setting.Conclusions: Based on the extant studies, TP seems to be generally feasible and acceptable to key stakeholders. However, thisreview detected a gap in the literature regarding TP's effectiveness and implementation process in the ED setting. Specific attentionshould be paid to the examination of this service for specific groups of patients, as well as its use to enable assessments for possibleinvoluntary commitment.