Adolescent Depression, Telepsychiatry, and Access

Adolescent depression is prevalent, undertreated, and associated with long-term morbidity if left untreated. Several structural barriers impede timely access to specialty mental health care in this age group. Telepsychiatry, including therapist delivered videoconference psychotherapy and internet delivered cognitive behavioral therapies (ICBT) have been developed to expand access and continuity of care for adolescents. This modality, however, has not been thoroughly evaluated to determine the effectiveness of telepsychiatry in improving access to services and its ability to reduce depressive symptoms in adolescence. A structured literature review identified six primary studies and four complementary systematic reviews evaluating this topic. Randomized trials show that telepsychiatry using therapist supported internet delivered cognitive behavioral therapy can produce results in symptom reduction and potential remission. The overall body of evidence seems promising but highlights the need for rigorous youth specific trials focusing on standardized interventions, addressing equity gaps, and long-term follow-ups. Future studies can be used to determine proper usage of ICBT along with ways of improving access to ensure adolescent depression is addressed equally across the United States.