Telepsychiatry Initiative Supports Rural Texas Hospital EDs

A telepsychiatry initiative launched by Texas Tech University Health Sciences Center (TTUHSC) is linking psychiatrists and other behavioral health providers via telemedicine to rural hospital emergency rooms and departments across Texas.

The TTUHSC Division of Strategic Initiatives has hired a team of psychiatrists and is working with the nonprofit Texas Organization of Rural and Community Hospitals (TORCH). The collaboration started with two hospitals in April 2024: the smallest TORCH hospital, Knox County Hospital, in Knox City, and the largest, Titus Regional Medical Center (TRMC), located in Mount Pleasant.

“Many times, patients with psychiatric illness don’t have the primary care they need, or they don’t have local psychiatrists,” explained Cynthia Jumper, M.D., M.P.H., TTUHSC's executive vice president for health policy and strategic initiatives, in a statement. “The only choices are either taking them to the emergency room if they’re in a crisis, or unfortunately, calling the police because they may or may not be violent or acting in a bizarre manner, and then they’re taken to jail. In rural hospitals, if a patient is in crisis and doesn’t have access to a psychiatrist, they usually have to stay in the emergency room under guard for two or three days hoping that the crisis will disappear.”

Titus Regional serves a population of about 82,000 people across five counties and is the last remaining independent hospital in northeast Texas.

“Titus has seen four hospitals close within 45 miles of us in the last 10 years,” Terry Scoggin, chief executive officer of TRMC, said in a statement. “We know the impact of a hospital closure on a rural community; it’s devastating. We also know the impact of behavioral health on rural communities. It is one of the largest issues that we’ve been dealing with over the last decade — the increase in behavioral health patients coming to our emergency department and being boarded in our emergency department.”

In May 2023, Healthcare Innovation conducted an in-depth interview with Scoggin about the challenges Titus Regional faces. 

Although TORCH has 157 member hospitals under the umbrella of their professional agency, some of those are connected to large healthcare systems and have access to psychiatrists. Currently, TTUHSC is working with about 15 to 20 hospitals, and Jumper said they hope to increase that.

For the initiative TTUHSC developed and built a scheduling and telehealth platform, Jumper added. “Our primary job at TTUHSC is to look for gaps in care, especially in rural hospitals, and to provide solutions and work with other people. We, as Texas Tech University Health Sciences Center, can’t come in and fix all the problems, but we can work collaboratively with whatever resources are in those rural areas. Then we can come in and be part of the solution.”