Telepsychiatry is expanding as a care modality that can leverage technology to maximize a limited supply of child and adolescent specialists. As a patient population, youth are particularly well suited for technology-based care delivery, typically regarding virtual treatment as not only acceptable, but preferable, to in-person care that includes long wait times and unnecessary physical travel. The youth telepsychiatry research is currently focused on synchronous models, with outcomes that include increased care access and quality across a variety of models and settings, as well as diverse youth populations. Youth-specific settings with a growing evidence base include school and juvenile justice, and there are also documented applications in daycare and child welfare agencies. There is less research regarding asynchronous applications with youth populations. As the adult telepsychiatry literature identifies expanding cost savings and efficiencies associated with this store-and-forward model, however, it is likely to receive more research attention as a promising model in pediatric and other youth settings.

The majority of youth-specific telepsychiatry considerations mirror in-person care considerations and include obtaining informed consent from parents/guardians in addition to obtaining youth consent and identifying appropriate strategies to solicit youth and parent/guardian input, both separately and in group settings. A potential benefit associated with the virtual medium is the ability to observe youths’ natural interactions with other family members via camera, which clinicians report, is more easily forgotten by young patients than the in-person presence of the psychiatry specialist. A challenge specifically associated with the virtual medium includes online prescribing limitations associated with common prescriptions for childhood behavioral challenges. With the evidence base for telepsychiatry continually growing and policy decisions providing increasing support for virtual care applications, child and adolescent telepsychiatry currently faces payment and reimbursement issues as its predominant obstacles. As research increases for home-based applications and practices and payors develop and pilot new and innovative payment models, it is likely that models and applications of child and adolescent telepsychiatry will continue to expand opportunities for increased care access, quality, and efficiency.