Telepsychiatry is the use of live video or pre-recorded video to communicate across different systems of care, across county lines, and to reach people living in rural areas who do not have resources nearby. Telepsychiatry can also expand the mental-health workforce by providing education to skilled nursing facilities through consultations about complex cases. This study will measure data and health-care savings from reduced use of involuntary emergency room visits and psychiatric hospitalizations of highly vulnerable populations with multiple mental-health conditions living in skilled nursing facilities located in rural areas.