Telemedicine in a child and adolescent mental health service: participants' acceptance and utilization.

Video-conferencing equipment was set up in Scotland in response to the increased pressure faced by the child and adolescent mental health services (CAMHS), and the need for specialist services to be accessible to, and harmonize with, 'mainstream' health services. Three sites were linked to the inpatient service in Edinburgh. Data were collected via questionnaires and diary logs. During a 24-month study, a total of 65 adolescents were admitted for inpatient care, of whom only five had their cases reviewed and monitored in a total of 20 teleconsultations. Adolescents and their carers involved in the study expressed great satisfaction with telemedicine and were keen to use it. Clinicians were resistant to telemedicine, with consequently low levels of utilization. Our results suggest that managers may be unwilling to re-allocate funding away from staffing, even where these costs are small and represent considerable improvements in the process of care for patients. Widespread integration of telemedicine to CAMHS is likely to be hard to achieve.