The importance of collaborative care within the telepsychiatric care setting

In 2024, approximately 25% of adults in the United States, or 60 million persons, had a mental health condition. It is well established that those with psychiatric diagnoses experience a reduction in life expectancy compared to those without and are more likely to experience a greater burden of medical comorbidity. Despite the increased risk of multiple medical comorbidities among those with psychiatric diagnoses, as many as 20% of individuals experiencing mental health challenges do not receive primary care services. In some cases, psychiatric providers might be the only source of medical care for those receiving mental health treatment. While psychiatric providers often focus on the psychiatric interview and mental status examination, it is also imperative that providers adequately identify medical comorbidities to facilitate referral to primary care as needed. This article provides a brief overview of three clinical cases, underscoring the importance of addressing medical comorbidities and engaging in collaborative care within the outpatient telepsychiatric setting. Case examples include hypertensive crisis requiring emergency evaluation; Wolff-Parkinson-White syndrome in a patient with anxiety; and lithium-exacerbated hypothyroidism, each underscoring the need for psychiatric providers to be cognizant of medical comorbidities that warrant referral or emergency evaluation.