When Medication is not enough: Impact of Telehealth on Mental Illness 

 

Esther Narkie Okang, MPA, MS, BS 

PhD Student, College of Nursing 

University of Utah 

Not all wounds are visible 

 

Introduction 

Although each of us have not been clinically diagnosed with a mental health disorder, I believe when faced with stressors, we each exhibit signs of mental health which when it undetected can impact our mental health. In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Mental illnesses are so common that nearly 1 in 5 adults in the US is living with one. With the current rise in COVID and many people self-isolating, the demands of mental services have increased as a result of people’s anxiety and depression levels have.

Traditional method of delivering therapy to individuals with mood disorders 

Prior to the recent pandemic (COVID-19), individuals with mood disorders had the flexibility of sitting face-to-face with a licensed psychologist or licensed therapy to talk through their issues which are usually behavior. We must take into consideration all the negative consequences of depression on both an individual’s well-being as well the economic impact. 

In a typical scenario where there is no pandemic, the first line of treatment for an individual with depression will be with anti-depressants but this has become a challenge because “how do I know” if what I’m feeling is associated to my illness, condition, or just part of "growing up?” 

 Pandemic being a driving force to shift from traditional in-person appointments to over-the-phone consultations and virtual appointments.  

 

Communication Change 

Although technology becomes an important role in delivery health resources, the old paradigm of administering therapy sessions to someone encountering anxiety has shifted. Individuals are to calling to make appointment to go and sit or lay on a couch while they talk through their anxiety, depression or any other mental issues has changed. For someone with an anxiety problem, being able to attention a session is a huge challenge. Individuals have now adapted to that way to doing things but now with everything going on, they have been asked to shift from what has become normal in their routines to something new.  As the prevalence of technology usage increases in every household within the United States, technology itself has become more apparent resource in health-care provision. 

 

Effectiveness of Telehealth in Behavioral Health 

Currently, there is enough evidence that shows that physician using telehealth in facilitating better and positive outcomes within the patients. Like other types of health care, behavioral health has its own set of challenges that can impact the delivery, access, and provision of services. The barriers might look a lot different for individual in rural settings. Lack of infrastructure, flawed healthcare system, and insurance company requiring proof of “medical necessity” to cover visits to providers and in-patient services are some common barriers to mental health care services prior to the onset of pandemic caused by coronavirus. In fact, “60% of US counties do not have a practicing psychiatrist.”

 

Privacy for those Seeking Treatment Electronically 

For individuals seeking treatment face-to-face, privacy is very important when it comes to mental illness. It is less likely for someone to be identified as seeking treatment just by going to a doctor's office. Telehealth can services has resulted in a lot of patient satisfaction which has also altered treatment improvement for patients. By providing video conferencing, individuals have been able to remain in their home or other comfortable place that they might find themselves to seek treatment. 

 

Telehealth Reimbursement Policy 

Reimbursement to providers offering telehealth services can be very tricky, currently the Center for Medicare and Medicaid Services (CMS) only reimburse some providers and not all providers. Due to these barriers some patients are currently not seeking the treatment that they need for their behavioral issues, hence individuals with mental illness could be self-medicating themselves.  

 

Future Direction 

There is so much stigma surrounding mental health and there are still ongoing barriers which exist to both accessibility and affordability for mental health treatment services across the United States. An increase in the utilization of telehealth between providers might help us to close the gap for individuals who need the treatment services. Since the impact of COVID- 19 is not only affecting one area of health services, I believe there should be additional efforts put into place to incentivize patients who choose to adopt telehealth as part of their treatment. 

 

Conclusion 

As our societal trend changes and access to technology becomes more readily available, we must as researchers and health care services providers also change with those trends. Telehealth is important to the success of health care delivery. We must increase the ability of how our patients access it and close some of the backlog that in-patient visit cost. 

 

References 

 

Luo C. et al (2020): A comparison of electronically delivered and face to face cognitive     behavioural therapies in depressive disorders: A systematic review and meta-analysis, EClinicalMedicine. https://doi.org/10.1016/j.eclinm.2020.1

 

Image Graph Courtesy : https://www.nimh.nih.gov/health/statistics/mental-illness.shtml.