Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Joan Kearney


The prevalence of PTSD has increased from 6.8% to 20% since the start of the Covid-19pandemic. For American Indians, the prevalence of PTSD ranged between 16 to 24% prior to the start of the pandemic. American Indians living in rural and tribal communities often experience significant barriers to accessing quality mental health treatment. For these reasons, telepsychiatry is a necessary tool to increase access to care. An entirely home based telepsychiatry program was developed and adapted for PTSD patients within a tribal community and implemented over 12 weeks. 40 patients were engaged at the initiation of the program and a total of 37 remained through the entirety of the program. Patient experiences were assessed based on appointment attendance, the administration of the PCL-5 pre and post program implementation, and patient and staff program evaluations. During the 12 weeks of this program, there was a 4% decrease in patient no shows and rescheduled appointments increased by 23%. Of the 37 patients that completed the program through the 12 weeks, 43% expressed a reduction in PTSD symptoms, 49% saw no change and 8% reported a worsening in PTSD symptoms. Telepsychiatry is a quality treatment delivery method that improves health equity for disadvantaged populations. while also reducing barriers to treatment. Telepsychiatry is comparable to traditional in-person treatment when comparing patient attendance as well as program evaluations. Clinical policies need to address how telepsychiatry can be integrated with in-person care to ensure patients are afforded various options of quality care.


This is an Open Access Thesis.

Open Access

This Article is Open Access