Psychiatry resident uses telepsychiatry to reach patients

Nita Bhatt, a psychiatry resident at the Wright State Boonshoft School of Medicine.

When she first started treating patients through telepsychiatry, Nita Bhatt, M.D., a psychiatry resident at the Wright State University Boonshoft School of Medicine, was skeptical.

“I thought it would be more difficult to form a therapeutic alliance over a screen,” said Bhatt, who is the administrative chief resident in psychiatry at Wright State. “I was wrong. Many of my patients with intellectual disabilities prefer to have their appointments through telepsychiatry.”

Telepsychiatry enables psychiatrists to reach patients in rural areas and those who have limited access to care. It provides patient-centered care through real-time video and audio interaction with a psychiatrist in addition to a multidisciplinary treatment team. It also reduces the cost of health care for those patients. Through telepsychiatry, physicians can provide a range of services, including psychiatric evaluations, therapy, education and medication management.

Bhatt treated patients through the Ohio Telepsychiatry Project, which provides access to high-quality care and community health for people in remote areas who are affected by co-occurring mental illness and developmental disabilities. The project is funded by grants from Ohio Department of Developmental Disabilities and Ohio Department of Mental Health and Addiction Services. As Bhatt treated her patients, she wanted to gain more insight into how the process could be modified for patients with Down Syndrome and Autism Spectrum Disorder.

“Patients with Down Syndrome have difficulty recognizing facial expressions as well as social cues. They have anatomic abnormalities that affect speech,” said Bhatt, who entered psychiatry to help change the way society views mental illness. “Patients with Autism Spectrum Disorder have deficits in social behaviors, eye contact, facial expressions and body gestures.”

She wanted to determine the webcam screen display preferences in these patients. So she applied for a grant. In December 2016, Bhatt received a one-year, $2,200 grant from the Dayton Area Graduate Medical Education Community (DAGMEC).

“As a psychiatrist, I feel it is important for me to advocate for my patients,” said Bhatt, who serves on the Ohio Psychiatric Physicians Association Public Health Committee and participates in the organization’s Advocacy Day, the day when psychiatrists and residents seek out legislators to advocate for patients regarding issues ranging from child sexual abuse to the heroin epidemic.

In February, she gave a presentation, “Treating Individuals with Intellectual Disability: The Resident Perspective,” at a Dayton Psychiatric Society meeting. In April, she will give another presentation, “The Doctor Can See You Now: Telepsychiatry Webcam Screen Display Preferences in Individuals with Down Syndrome or Autism in a Community Mental Health Center,” at the Virginia C. Wood Resident Research Forum in Dayton through DAGMEC.

In May, she will present her research at the American Psychiatric Association Annual Meeting in San Diego. She will give a workshop, “Break on Through to the Other Side with Telepsychiatry and Intellectual/Developmental Disability Psychiatry,” and present a research poster, “Can You See Me Now? Telepsychiatry and Intellectual/Developmental Disability.”

Bhatt also is a clinical instructor in psychiatry. In 2015, she was named Psychiatry Teacher of the Year at the Boonshoft School of Medicine. She teaches motivational interviewing, a goal-directed technique that focuses on the patient’s intrinsic motivation to elicit change. The technique recognizes and accepts that each patient is at a different stage in his or her path to change.

“I have enjoyed teaching medical students and residents about psychiatry,” said Bhatt, who earned her undergraduate degree at the University of Akron and her M.D. and M.P.H. degrees at St. George’s University in Grenada, West Indies. “I also have appreciated the opportunity to serve as a mentor to many of the medical students with whom I have worked.”

In June, she will finish her fourth and final year as a resident at the Boonshoft School of Medicine.

“I really enjoy working with our faculty members and appreciate their commitment to teaching,” said Bhatt, who is originally from Columbus, Ohio. “The program not only provided me with a strong background in the biological aspects of psychiatry, but it also emphasized psychotherapy, which has allowed me to understand my patients on many levels.”

She also has appreciated working with her mentor, Julie Gentile, M.D., professor and interim chair of the Department of Psychiatry. Gentile is the project director of the Ohio Telepsychiatry Project.

“Without Dr. Gentile’s guidance, none of this would have been possible,” Bhatt said. “Dr. Gentile’s passion for psychiatry and treating patients with intellectual disabilities is contagious. She has opened doors for me that I never knew existed.”

This summer, Bhatt will join the Wright State University Department of Psychiatry as a faculty member working with Twin Valley Behavioral Healthcare Hospital, the state psychiatric hospital in Columbus. She will also continue her work with the Ohio Telepsychiatry Project.