The challenges of telemental health and how they can be improved

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

Mental health meetings do not usually involve the collection of vital items or samples, nor do they require an absolute face-to-face meeting (although therapists may observe physical signals throughout the body in person). Just talking, through video or even just audio, is enough.

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 observations on the greatest ways in which telehealth is changing mental health treatment in America, what the impact is has demonstrated increased access to telehealth for mental health treatment, the challenges that telehealth poses in mental health treatment, and what improvements can be made in telehealth for mental health treatment?

Q. What are the biggest ways in which telehealth is changing the way the United States treats mental health problems?

A. Prior to COVID-19 and historically in the United States, there was a negative stigma surrounding receiving mental health care. Although there were many movements and campaigns trying to remove the stigma, many people were discouraged from seeking professional help due to lack of coverage in health plans, high payments and fear.

With the expansion of telehealth, the availability of mental health services continues to grow and is more accessible than ever. Gone are the days of driving to commitments and sitting in a waiting room, with the feeling that all eyes are on you. Social networks have also created a platform for mental health activists, and in real time we are seeing an increase in people seeking treatment or routine mental care.

COVID-19 has accelerated the need for more access and new ways to treat mental health, such as telehealth. As a result of the COVID-19 pandemic, we have also seen many large insurance companies offer permanent or temporary benefits under a plan that includes mental health services.

Telehealth has made it easier for insurers to include these benefits in their plans at a lower cost to patients. In many cases, insurance providers even waive the full cost of visits when using telehealth.

While most people do not want to be thought of or treated differently because they choose to seek mental health treatment, the stigma surrounding this can make them feel doomed and avoid choosing care.

Telehealth has made it possible for people to now have access to care from the privacy of their homes, making the decision to seek care much easier and more convenient. Being able to talk to a mental health professional from home has given patients the opportunity to choose the environment that provides the most comfort, making the process of opening up and sharing concerns with a new person much easier.

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

A. The COVID-19 pandemic has changed Americans across the country, affecting mental well-being, such as working from home, quarantining, not having time with friends and family, and feeling isolated.

This has led to an increase in mental health problems, with most non-emergency medical treatments being closed due to safety concerns and quarantine. Telehealth was a necessity we did not expect to come, and the pandemic accelerated this service due to the timely needs that arose.

With the growing demand for mental health care, telehealth is the answer for many. People living in rural or underserved areas, in particular, have limited access to special health services, especially mental health. One of the key impacts of increased access to telehealth is that these communities have been 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 personal care is not the hard part, but it can be difficult to afford it. Another key impact of increased accessibility is that telehealth is usually a much more cost-effective option, as regular personal care can be more than twice the cost.

Think about all the money and time lost to have to leave work, which can lead to lost wages, the need to hire a babysitter, or pay for gas when traveling to and from meetings. With telehealth, patients can afford the planned time at a convenient and convenient time for them.

In addition, while most offices provide services during standard business hours, many mental health services also provide pre- and post-business care, so patients have more flexibility in planning.

There are also many cultural barriers and health inequalities that many minority communities experience that may discourage them from seeking mental health care.

During the pandemic, these communities experienced an increase in the use of mental health. Although there are several reasons why this rise has occurred, we have seen that Telehealth has managed to overcome some of the barriers that these groups have had to overcome.

On the one hand, the accessibility of telehealth has made services much more accessible to minority groups or people on lower incomes, which allows them to include mental health care in their budgets. In addition, minority groups have experienced higher levels of depression and anxiety only exacerbated by the pandemic, so demand from these communities, along with a reduction in the negative stigma surrounding mental health care through telehealth, has led them to these opportunities.

Finally, telehealth allows those with language barriers in the United States to have access to a wider group of mental health professionals who can provide a better understanding of their cultural background, in partnership with the ability to speak their preferred language. .

Q. What are some of the challenges that telehealth poses in the treatment of mental health problems and when personal care should be sought?

A. While telehealth has expanded access to mental health care for so many people across the country, there are still restrictions that may make some prefer personal care.

First, confidentiality. While many patients prefer telehealth to be able to make an appointment in the privacy of their homes, there are situations in which people may not have the same privacy at home.

Some people may live in multi-generational homes where others are at home and in their ears, or they may share a room with others, and privacy is not immediately available. This can allow patients to take their calls from their car, which is not always convenient or preferred. As a result, people in these conditions may prefer personal care.

Second, safe places. While some people prefer virtual care for a variety of reasons, others feel that virtual mental health care is cold and distant, and prefer personal care to feel more engaged with their mental health provider. Sometimes removing them from a normal home environment can help create a safe place for the patient to discuss their mental health issues.

This is a particularly important factor for live support groups, which can be more engaging and easier in person than virtually. Many times, live support groups are used for people who want to overcome addictions, and being able to separate them from their traditional environment can be helpful in getting them out of their environment, even for a moment.

And third, technology. Some people may not understand the technology behind applications or websites that provide mental health services. They may not know how to access video connections or use their phone to contact a provider, which can lead to a session below face value in which they do not feel comfortable or at ease.

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

Q. What improvements can be made in telehealth specifically to treat mental health problems?

A. We can look at the current challenges of the telehealth space to find where to start by improving the telehealth experience for all.

For starters, creating wider Internet access allows telehealth to reach more people who may not have options available today. In fact, the Biden administration recently secured commitments from 20 leading ISPs to either reduce prices or increase speeds to serve low-income households.

This is a great step in the right direction. Better cellular and Internet speeds allow more mental health experiences to be stored through video rather than the telephone, where mental health professionals can better assess their patient through verbal and nonverbal cues.

With all the advances and changes we’ve seen in technology in just the last few decades, patients and providers need to keep up with a lot. Education is key to ensuring that telehealth remains and continues to grow in availability. Many vendors are willing to learn new technologies, but need to be trained by people who fully understand the intricacies of these systems.

As new standards of care are set by technological advances, providers and patients need to be educated to keep up with these evolving standards. It is important for those implementing new systems to provide appropriate educational services that need to learn the technology, as well as help their patients.

Another thing to consider is how to help patients with disabilities through telehealth. There are laws in the United States that guarantee equality of care for people with and without disabilities, and therefore health situations must be taken into account, such as providing additional instructions or scheduling longer appointments.

Sometimes it is necessary to make additional maintenance or modifications of technological systems to support these patients. Telehealth systems must meet accessibility requirements and must provide resources that are available in multiple formats, such as audio recordings or large text sizes.

Twitter: @SiwickiHealthIT
Send an email to the writer: [email protected]
Healthcare IT News is a media publication of HIMSS.

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