[Photo: Dr. Carly McCord]

As telehealth takes off as the next big way to provide cost-effective health care to underserved populations, a group at Texas A&M University sees it as confirmation of what they’ve been doing for years.

The Texas A&M Telehealth Counseling Clinic (TCC) utilizes doctoral students in psychology to provide mental health counseling to people in rural areas of the Brazos Valley region who would otherwise lack such services. The graduate counselors work out of their clinic’s offices on the Texas A&M campus in College Station, but the clients stay near their homes in five Brazos Valley counties. A secure, high-speed video link connects the two.

The clinic is an interdisciplinary collaboration between the Texas A&M School of Public Health and the College of Education and Human Development. The counseling psychology program at Texas A&M is the only American Psychological Association (APA) accredited program in the nation that includes a telehealth clinic.

“It’s a mutually beneficial relationship,” said Dr. Carly McCord,  director of clinical services at TCC and an assistant professor at Texas A&M. “Students get training and experience with the technology and with different populations—experience that will serve them well when they begin their professional practice.

Former TCC students have gone to work for the U.S. Department of Veterans Affairs (VA), which Dr. McCord says is the largest provider of telehealth services. “The VA demonstrated that telepsychology services reduced inpatient mental health care utilization by 25 percent, and although rates vary, it costs at least $400 per day to keep someone in an inpatient facility,” Dr. McCord said. A 2010 report by the Texas Hospital Association shows the average inpatient stay in areas around the Brazos Valley is about eight days. Therefore, for each person the clinic can keep out of inpatient care, at least $3,200 is likely saved.

The counties served by the TCC benefit too in the form of health care cost savings. “There is a cost avoidance factor if we can keep people from going to the emergency room every time they have a panic attack, and I’ve heard anecdotally we do,” Dr. McCord said. “Still, it’s important to remember that although cost savings can help convince counties to participate, the primary goal is quality care for patients.”

Part of that quality is the fact that people get better access to care because they don’t have to travel an hour or more to Texas A&M. Instead, the TCC has worked with a variety of community partners so clients can access care within their county.

“The people in the community are what have made this program so successful,” Dr. McCord said. “That’s the public health mindset that I wasn’t taught in my counseling graduate training.”

In addition to using educational psychology students as counselors, the clinic employs public health students in research and outreach positions. To date, they’ve served more than 700 clients and provided approximately 7,000 counseling sessions.

Both individual and group counseling is provided. Dr. McCord and graduate student counselors wrote about delivering group counseling services over videoconference in The Journal for Specialists in Group Work.

“My vision is that the TCC will be at the forefront of telehealth training. First and foremost the TCC serves as a clinical setting for students from multiple disciplines to apply what they are learning in the classroom and positively impact the communities in which they live,” Dr. McCord said. “Secondarily, the expertise gained can be applied to consult with and assist other universities to incorporate telehealth into their training. Finally, the TCC has demonstrated commitment to providing training to licensed professionals by developing continuing education courses.”

“There’s a huge gap between where technology has grown to be and what many of our young professionals will be prepared to fully utilize when they graduate,” Dr. McCord said. “The TCC is working to bridge that gap.”