Biomedical subjects

Steven E Hyler

Publications and source records attributed to Steven E Hyler.

11 recordsLinked to original sources

PubMed2005

Hollywood portrayals of child and adolescent mental health treatment: implications for clinical practice.

This article examines the portrayals and myths of child and adolescent psychiatry relevant to the current practitioner. Although behavioral and emotional problems abound onscreen, the formal diagnosis of youth mental illness is uneven and rare. Common myths of brainwashing, incarceration, parent blame, parent supplantation, violence, and evil are explored, with current commercial examples of each. The impact of these portrayals on young patients, peers, parents, and the public at large are examined through the prevalence of different stereotypes across different genres more likely viewed by different ages. Positive and negative depictions of illness and treatment are identified for education and awareness, and the authors provide advice for using Hollywood films successfully as a helpful intervention in the mental health treatment of children and adolescents.

Adolescent↗

PubMed2005

Can telepsychiatry replace in-person psychiatric assessments? A review and meta-analysis of comparison studies.

OBJECTIVE: The authors conducted a review and meta-analysis of the literature comparing telepsychiatry with "in-person" psychiatric assessments. METHOD: Approximately 380 studies on telepsychiatry published between 1956 and 2002 were identified using MEDLINE, PsycINFO, and cross-referenced bibliographies. Of these, 14 studies with an N > 10 compared telepsychiatry with in-person psychiatry (I-P) using objective assessment instruments or satisfaction instruments. Three of these studies compared high bandwidth (HB) with low bandwidth (LB) telepsychiatry. RESULTS: Fourteen studies of 500 patients met inclusion criteria and were included in the meta-analysis. Telepsychiatry was found to be similar to I-P for the studies using objective assessments. Effect sizes were on average quite small, suggesting no difference between telepsychiatry and I-P. Bandwidth was found to be a significant moderator. Three moderators were tested, effect sizes remained largely heterogeneous, and further analyses are needed to determine the direction of effect. There was no difference between I-P and telepsychiatry between the HB and LB groups, although there are anecdotal data suggesting that HB was slightly superior for assessments requiring detailed observation of subjects. CONCLUSION: Out of a large telepsychiatry literature published over the past 40+ years, only a handful of studies have attempted to compare telepsychiatry with I-P directly using standardized assessment instruments that permit meaningful comparisons. However, in those studies, the current meta-analysis concludes there is no difference in accuracy or satisfaction between the two modalities. Over the next few years, we expect telepsychiatry to replace I-P in certain research and clinical situations.

Humans↗

PubMed2005

Problems with the electronic medical record in clinical psychiatry: a hidden cost.

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Cost-Benefit Analysis↗

PubMed2004

Legal and ethical challenges in telepsychiatry.

Telepsychiatry in the 21st century poses a wide range of legal and ethical challenges. The authors review issues related to licensure, credentialing, privacy, security, confidentiality, informed consent, and professional liability in the use of telepsychiatry services and illustrate the discussion with hypothetical clinical vignettes. It is clear that there will be a need in the immediate future to create legal instruments as well as formal professional ethical guidelines for the practice of telepsychiatry.

Confidentiality↗

PubMed2003

Virtual Briefcase-Psych network version 2.0.

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Journal Article↗

PubMed2003

A review of the costs of telepsychiatry.

OBJECTIVE: S: The issue of whether telepsychiatry is worth the cost or whether it pays for itself is controversial. This study investigated this question by reviewing telepsychiatry literature that focused on cost. METHOD: S: Approximately 380 studies on telepsychiatry published from 1956 through 2002 were identified through MEDLINE, PsycINFO, and cross-referenced bibliographies. Of these, 12 studies with samples of more than ten persons or programs focused specifically on the cost of telepsychiatry. RESULTS: The methods of examining cost used in the 12 studies were cost-feasibility, cost surveys, direct comparison of costs of telepsychiatry and in-person psychiatry, and cost analysis. It was concluded that in seven of the studies reported, telepsychiatry was worth the cost. One study reported that telepsychiatry was not financially viable. Three studies of cost-effectiveness reported the break-even number of consultations, the number that make telepsychiatry comparable in cost to in-person psychiatry. One review concluded that the lack of a clear business plan contributed to the difficulty of determining whether any of the programs was cost-effective. CONCLUSION: S: Telepsychiatry can be cost-effective in selected settings and can be financially viable if used beyond the break-even point in relation to the cost of providing in-person psychiatric services. Whether governmental or private health agencies value telepsychiatry enough to assume its cost is a question that remains to be answered.

Health Care Costs↗

PubMed2002