Telemedicine and geriatric psychiatry: directions for future research and policy.

The use of telecommunications to provide mental health services at a distance has grown rapidly in the past 10 years. The overall experience has been positive, but evaluations and reliability studies have been preliminary. A fundamental question of what constitutes adequate technology for telepsychiatry remains unanswered. As technology and equipment capability change rapidly, a more important question may be what clinical decisions and behavioral observations are required to produce high standards of distance mental health care. Geriatric patients may have sensory impairments and unique aspects to their psychiatric problems that can make telemental health assessments more challenging. It is not clear what model of telepsychiatry constitutes the best practice for geriatric psychiatry. Future research and program evaluations should address these questions to guide the use of telepsychiatry in productive directions.