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Winter 2012

Extending the Reach

Date: February 1, 2012

Fishkind: Extending the Reach
Fishkind: Psychiatric help is just a teleconference away.

Through telepsychiatry, Avrim Fishkind can aid many more patients in crisis.

When a man with bipolar disorder is standing on a crowded street with a gun in his hand, it’s unlikely that he’ll call on a psychiatrist to talk him out of pulling the trigger. In fact, if he was ever willing to ask for help, it would most likely have been days or weeks earlier, when his crisis was just beginning. If he lived in a small community with poor resources, chances are that psychiatric care was hard to come by.

For years, says emergency psychiatrist Avrim Fishkind ’91, a lack of resources has plagued local emergency departments, which are overrun by psychiatric patients they are ill equipped to handle. He’s also seen firsthand how crucial psychiatric care can be in emergency situations. In 2005, he implemented psychiatric emergency services at the Houston Astrodome, after 25,000 people converged on Texas from New Orleans, to escape the floods of Hurricane Katrina. It was the largest ever psychiatric emergency response to a disaster. The next year, troubled by the number of patients stuck for days in an emergency room while waiting for psychiatric care, Fishkind helped the state of Texas rewrite its policy on handling patients in psychiatric crisis. The result: legislation that infused more than $100 million over six years to build a comprehensive psychiatric emergency system across Texas. But more needed to be done.

“Over time we’ve started to realize that 99 percent of psychiatric emergencies weren’t being seen by emergency psychiatrists because they were occurring on the streets, in schools, hospitals, and jails, where there often are no psychiatrists available. It was clear that we needed more psychiatrists to handle these patients,” says Fishkind.

And yet the shortage of psychiatrists across the United States has been widely acknowledged. “The only solution I could think of was telepsychiatry,” he says. And so in 2007, JSA Health Telepsychiatry was born.

Through Fishkind’s company, psychiatrists can be available to facilities in need on a moment’s notice. For hospitals, schools, prisons, or any other institutions or settings that might be handling patients in psychiatric crisis, JSA Health psychiatrists are available via teleconferencing 24 hours a day, seven days a week.

The company is one of only three offering similar services across the country, and so far it’s proving successful, with a growing client list and an increasing list of satisfied users. “A psychiatrist sitting in Houston can help eight different hospitals across the state or farther, all in the course of a shift,” Fishkind says. “It’s the wave of the future in psychiatry.”  LG