One of the biggest barriers that prevent many people from going to the doctor for adequate medical care is transportation — actually getting to your medical appointment can be a huge challenge. Whether it’s a lack of transportation, a significant distance to drive, a behavioral health issue or other disability that prevents them from traveling, transportation is a barrier that needs to be considered when discussing medical care that works for everyone. The introduction of telehealth, or virtual health, will be a game-changer for vulnerable populations receiving care, as well as for coordinating treatment with other providers.
Telehealth is the distribution of health-related services and information via electronic and telecommunication technologies. Most common is the act of talking to a doctor via video conferencing by using the video chat options on your phone or computer, rather than heading into an office. Other examples of telehealth are communicating via texts, secure emails, webinars, and apps. While the use of these methods is still evolving across all practices, the ability to talk to a doctor without leaving home could be particularly helpful for behavioral health organizations. Compared to other disciplines, psychologists, and other mental health clinicians could find more of a benefit from telehealth sessions or video conferencing by connecting with clients who may not otherwise be able to seek treatment.
Let’s take a look at the ways that behavioral health organizations can benefit from this technological advancement.
Reach Reluctant Patients
According to the Behavioral Health Workforce Research Center at the University of Michigan, in 2016, more than half of the 44.7 million adults in the U.S. with mental illnesses, and approximately 35 percent of the 10.4 million adults in the U.S. with serious mental illnesses, did not receive mental health services. Not receiving treatment can be traced back to a stigma around mental health issues in general — “individuals living in rural locations commonly identify a lack of privacy as a barrier to receiving treatment. Associated with the lack of privacy is the desire to avoid being the subject of gossip or being marginalized.” This displays that individuals facing mental illnesses would oftentimes rather not get the appropriate treatment for fear of discrimination outside of the care center. The ability to have a home visit with a doctor, then, could help those who don’t wish to publicly visit a therapist. To those suffering from mental conditions, Telehealth could be a more successful, less stigmatized treatment option.
Further, for many who suffer from depression, the thought of leaving the house to see a medical professional can be overwhelming. A trip to the doctor can cause more stress and anxiety than may seem worth it, even though seeking treatment may be the best step towards a better life. Behavioral health illnesses make every day decisions and actions more difficult, and if we want to efficiently reach these vulnerable populations, we need a medical catchment system that is specifically built with these populations in mind.
Telemedicine can help clients take the important first step — and even more importantly, the follow-through steps, needed to receive the appropriate treatment plans. Oftentimes, when individuals needing care for mental health issues do make it into a physical office or facility, there can be a lack of follow through on care. This is because depression and other behavioral health issues can make it difficult to complete tasks proactively with regards to day-to-day activities and responsibilities. But if we are considering these vulnerable populations seriously, we need a medical system that works for them, not us. If they cannot be proactive for whatever reason, we should have a system in place that is proactive on their behalf. A phone or video call is a much easier way to follow up with a patient than trying to schedule an in-person appointment. With so many Americans facing struggles with anxiety and depression, telehealth offers a new and much-needed treatment option for behavioral health individuals who face stigma and general lack of capacities.
Reach Rural Patients
For those who live in rural areas looking to treat mental illness, the best provider for their condition may not be the closest. Nearly one in five U.S. residents live in a rural area that are over an hour away from their best options for treatment. On top of this, according to most estimates, individuals living in rural locations experience mental and substance use disorders at rates that are similar to (and sometimes higher than) those of their urban counterparts. It is known, then, that rural populations are vulnerable, separated, and can easily be forgotten and removed. Telehealth communications would increase their chances of getting the help they need, no matter their distance, drastically.
Additional barriers and perceptions to healthcare exist in rural communities that should also be considered. Examples include the fact that behavioral health issues are often normalized in rural communities, making illnesses like addiction the “norm”. It has been said that rural communities also consider themselves more self-reliant, so less willing to seek help, than their urban counterparts. All the while, rural communities are becoming more and more culturally diverse: racial and ethnic minorities accounted for 83 percent of the population growth in rural areas from 2000 to 2010. This means that the distance to access appropriate healthcare, combined with the need for culturally appropriate care (language preference, beliefs, practices, etc.) make it incredibly difficult to choose far-away medical treatments rather than to simply stay “self-reliant” at home.
For those who work, don’t have time off, don’t have transportation, are the sole caretakers of children or family members, or simply can’t afford gas, traveling an hour or more for treatment multiple times a month is not just unrealistic, it’s impossible. New telehealth modules would solve this problem by providing care for patients in their homes, at work, or even in their cars. For all these reasons and more, telehealth is an important solution to consider.
In 2013, treatment for mental health disorders cost the nation $201 billion. Delivering care through telehealth can help reduce this cost, not only by eliminating the cost of travel for the patient, but by lowering the cost of care by cutting back on office visits. This would, in turn, lower the cost of Medicare, Medicaid or CHIP beneficiaries with behavioral health conditions. Further, 70 percent of people with a behavioral health issue also have a medical comorbidity, such as hypertension and depression. Having one online location where all of their needs can be met, like through telecommunications, means increased care coordination and better financial standing for providers.
Whether a client’s primary malady is behavioral or physical, there’s a cost to delivering care in a physical setting. Something as simple as adjusting medications can often be done in a more cost-effective way through a virtual setting, rather than requiring a trip into an office which may interfere with a client’s everyday life.
More Efficient Healthcare System
The benefits of using telehealth in behavioral medicine don’t stop at reduced costs and reaching more clients.
The immediacy of care is a big factor when treating mental health issues. Many looking for treatment for anxiety or depression often seek the help of a professional when they experience an episode. As it stands, it can be weeks or even months before they could be seen. Telehealth could help break down some of those scheduling barriers in order to help clients get seen sooner. The quicker they are seen, the less likely individuals are of falling between the cracks, and the more involved they can become with their own health decisions and outcomes.
This scheduling conflict is often exacerbated by the fact that the mental health workforce is under-resourced. There are more clients looking for care providers than can be provided at the moment. Telehealth can go a long way in closing this gap by providing a way for individuals to be taken care of in a much more efficient manner that also utilizes far fewer resources.
Perhaps the most appealing aspect of telehealth is that it can be more easily adapted to a client’s personal life and healthcare needs than traditional medicine. Many apps are being introduced to support telehealth that allows clients to check in when they can and, in turn, track their progress. Healthcare providers then monitor the apps and keep in touch with the client. Taking the time and effort to check in each week on a mobile app or online portal is a good sign that clients are following through with care and getting the help they need.
So far, the introduction of telehealth seems to be working. According to its research, Teladoc’s behavioral health services have seen meaningful symptom reduction, with a 32 percent decrease in depression symptoms, a 31 percent reduction in anxiety symptoms and a 20 percent reduction in stress symptoms.
As displayed, there are many instances where an in-person visit to an office or facility is just not needed, and where valuable time is wasted, for both the patient and the care provider. There are also times where individuals don’t feel comfortable waiting in a doctor’s office. There are even more times when reaching that appointment on time is just not possible. For these cases, telehealth is a productive and cost-effective solution that is respectful, dignified and considerate of patients’ holistic needs.
About Ted Wright, MHA: Ted Wright has over 25 years of experience in the health and human services delivery and technology market. Over the last 10 years, Ted has been one of the longest running sales leaders in the market. Prior to working in software sales, Ted consulted with behavioral healthcare organizations regarding all levels of process improvement from client throughput to complete upgrades to their electronic health records. Ted has worked with all levels from state and county agencies to private inpatient hospitals. Prior to working in technology, Ted worked in direct care management where he managed logistical coordination of rehabilitation services for a multi-independence level, thirty-bed head injury facility. Ted holds a Bachelor of Science in Psychology along with a Master’s in Health Administration.