Of all the medical specialties impacted by telemedicine during the pandemic, the one with perhaps the most significant and lasting effects is behavioral and mental health.

Mental health appointments generally don’t involve any collection of vital signs or samples, nor do they absolutely require a face-to-face meeting (although therapists may observe full-body physical signals in person). Just talk, via video or even just audio.

We spoke with Dr. Janice Johnston, Chief Medical Officer and Co-Founder of Redirect Health, a telehealth technology and services company, to get her expert insights into the key ways telehealth is changing American mental health treatment. , what impact increased accessibility to telehealth has had on mental health treatment, the challenges that telehealth presents in mental health treatment, and what improvements can be made to telehealth for mental health treatment?

Q. What are the key ways telehealth is changing the treatment of mental health issues in the United States?

A. Prior to COVID-19 and historically in the United States, there was a negative stigma around receiving mental health care. Although there have been many movements and campaigns to try to eliminate the stigma, many people have been deterred from seeking professional help due to a lack of coverage in health care plans, high copays and fear.

As telehealth expands, the availability of mental health services continues to grow and is more accessible than ever. Gone are the days of driving to appointments and sitting in a waiting room, feeling like all eyes are on you. Social media has also created a platform for mental health activists and we are seeing, in real time, an increase in the number of people seeking treatment or routine mental care.

COVID-19 has accelerated the need for better access and new ways to treat mental health, such as telehealth. Due to the COVID-19 pandemic, we have also seen many major insurance companies offer permanent or temporary employee benefits that include mental health services.

Telehealth has made it easier for insurers to include these benefits in their plans with less cost to patients. In many cases, insurers have even waived the full cost of visits when using telehealth.

While most people don’t want to be viewed or treated differently because they choose to seek mental health treatment, the stigma surrounding it can make them feel judged and avoid choosing care.

Telehealth has allowed people to now access care in the privacy of their own home, making the decision to seek care much easier and more comfortable. Being able to talk to a mental health professional at home has allowed patients to choose a setting that provides the most comfort, making the process of opening up and sharing concerns with a new person easier.

Q. What impact has increased accessibility to telehealth had on mental health treatment in the United States?

A. The COVID-19 pandemic has forced changes for Americans across the country that have affected mental well-being, such as working from home, quarantines, lack of time spent with friends and family, and the feeling of isolation.

This has led to an increase in mental health issues, with most non-emergency medical treatment halted due to security concerns and quarantine measures. Telehealth was a necessity we didn’t see coming, and the pandemic accelerated this service due to the ad hoc needs that arose.

With the increased demand for mental health care, telehealth has been the answer for many. People living in rural communities or underserved areas, in particular, have limited access to specialist health care services, especially mental health. One of the main impacts of the increased accessibility to telehealth is that these communities were able to turn to telehealth as an option when they may not have had an alternative.

Unlike rural or underserved communities, many urban populations see that finding in-person care isn’t the hardest part, but paying for them and getting to their appointments can be. Another key impact of increased accessibility is that telehealth tends to be a much more cost-effective option, as in-person care can regularly be more than double the cost.

Think of all the money and time wasted having to miss work, which can mean lost wages, having to hire a babysitter, or paying for gas on the way to and from appointments. With telehealth, patients can pay for their appointment at a time that is convenient and convenient for them.

Additionally, while most offices provide services during standard office hours, many telemental health services also provide care before and after hours, so patients have more flexibility when it comes to working hours. schedule.

Many minority communities also face many cultural barriers and health inequities that can deter them from seeking mental health care.

During the pandemic, these communities have seen an increase in the use of telemental health. Although there are several reasons why this increase has occurred, we have seen that telehealth has been able to combat some of the obstacles these groups have had to overcome.

On the one hand, the affordability of telehealth has made services much more accessible to minority groups or low-income people, allowing them to include mental health care in their budget. Additionally, minority groups have experienced higher rates of depression and anxiety, only exacerbated by the pandemic, so demand from these communities, as well as diminished negative stigma around mental care through telehealth , pushed them towards these options.

Finally, telehealth allows people facing language barriers in the United States to have access to a broader group of mental health professionals who can provide a better understanding of their cultural backgrounds, coupled with the ability to speak in their preferred language.

Q. What are some of the challenges that telehealth presents in treating mental health issues and where in-person care must be sought?

A. Although telehealth has expanded access to mental health care for so many people across the country, there are still limitations that may cause some to favor in-person care.

First, privacy. While many patients prefer telehealth so they can have their appointments in the privacy of their homes, there are situations where people may not have the same privacy in their homes.

Some people may live in multi-generational homes where others are home and within earshot, or they may share a room with others with privacy that is not immediately available. This can leave patients taking calls from their car, which isn’t always comfortable or preferred. Therefore, people in these settings may prefer in-person care.

Second, safe places. While some people prefer their virtual care for a variety of reasons, others find virtual mental health care cold and distant and prefer in-person care in order to feel more engaged with their mental health provider. Sometimes being removed from their normal home can help create a safe place for the patient to discuss their mental health issues.

This is especially a factor with live support groups, which can be more engaging and easier in person than virtually. Often, live support groups are used for people looking to overcome their addictions and being able to separate them from their traditional environment can be helpful in getting them out of their environment, even momentarily.

And third, technology. Some people may not understand the technology behind apps or websites that provide mental health services. They might not know how to access video links or use their phone to connect to a provider, which could lead to a poor session where they don’t feel comfortable or at ease.

Patients also do not want to see the time consumed or lost during their appointment due to technical difficulties and may prefer to see their providers in person to avoid the hassle of these situations.

Q. What enhancements can be made to telehealth specifically for the treatment of mental health issues?

A. We can look at the current challenges in the telehealth space to figure out where to start to improve the telehealth experience for everyone.

For starters, creating wider access to the Internet allows telehealth to reach more people who may not have any options available to them today. In fact, the Biden administration recently secured commitments from 20 major internet service providers to lower prices or increase speeds to serve low-income households.

It’s a big step in the right direction. Better cellular and internet speeds allow for more telemental health experiences to be conducted over video, not telephone, where mental health professionals can better assess their patient through verbal and non-verbal cues.

With all the advances and changes we’ve seen in technology over the past few decades, patients and providers have a lot to keep up with. Education is essential to ensure that telehealth remains and continues to increase in its availability. Many vendors are willing to learn new technologies, but need to be trained by people who fully understand the ins and outs of these systems.

As new standards of care are set by advances in technology, providers and patients must receive the training necessary to keep up with these evolving standards. It is important that those implementing new systems provide the appropriate training providers need to learn the technology and help their patients.

Another thing to consider is how to help disabled patients through telehealth. There are laws in place in the United States to ensure equal care for people with and without disabilities, and therefore considerations must also be made in telehealth situations, such as providing additional instructions or scheduling longer appointments.

Sometimes additional support or changes need to be made to technology systems to support these patients as well. Telehealth systems must meet accessibility requirements and provide resources available in multiple formats, such as audio recordings or large text.

Twitter: @SiwickiHealthIT
Email the author: [email protected]
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