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What’s Next in Virtual Behavioral Health?

Though the shortage of physicians and staff resources across virtually all specialties challenges healthcare organizations throughout the United States, the gap between supply and demand is particularly severe in behavioral health.

According to an article in JAMA, mental illness, including substance abuse, was the leading cause of disease burden in 2015, surpassing heart disease and cancer. Suicides among young people between the ages of 10 and 24 rose 47% between 2008 and 2019, according to a White House issue brief. The anxiety and social isolation wrought by the pandemic only deepened the problem. An estimated 50% of students reported symptoms of depression during the pandemic, while half of women and one-third of men reported deteriorating mental health, the White House brief notes.

While approximately one in five American adults—52.9 million people—experience some form of mental illness, according to the National Institute for Mental Health, many don’t receive adequate treatment. In fact, half of individuals age 18 and older with serious mental illness report that they did not receive needed care at least once in the previous year, the National Survey on Drug Use and Health shows.

The growing gap for behavioral health services

As healthcare institutions of all sizes and in all geographic locations know well, there simply aren’t enough psychiatrists, psychologists, chemical dependence specialists, and other behavioral health professionals available to treat the plethora of mental health ailments affecting Americans. The gap is substantial and growing. Seventy-seven percent of U.S. counties report a severe shortage of psychiatrists, according to a study by the National Council of Behavioral Health.

With the pandemic’s onset, healthcare organizations scrambled to set up remote medical services in keeping with federal and state safety mandates. Though they’ve learned that virtual visits work better for some types of individuals, conditions, and situations than others, the natural fit between behavioral health and telehealth stood out almost immediately.

Telehealth for behavioral health care, also known as telebehavioral health, telemental health, or telepsych, has quickly become the new normal for many behavioral health professionals and patients. According to a data analysis by consulting firm Mercer, outpatient behavioral health visits conducted via telehealth rose from 1% of encounters before COVID-19 to 50% by the second quarter of 2020 and stayed at that level through the third quarter of 2021.

Recent data shows that although virtual outpatient care has declined since 2020, 36% of patients with mental health and substance use disorders still use telehealth in 2022.

The convenience and privacy of virtual visits

Telebehavioral health continues to show promise as a strategy to narrow the gap between supply and demand now that the worst of the pandemic has passed. The use of virtual care platforms by health systems is helping them address the provider shortage, reduce wait times for care, and reach patients in remote and rural areas who might not otherwise have access to treatment. Virtual care modalities also alleviate the lingering stigma associated with mental illness by allowing patients to receive care in the privacy of their own homes, thus reducing appointment cancellations and supporting improved outcomes.

Behavioral health professionals and patients alike appreciate the convenience and time savings of virtual visits. But beyond these advantages, research reveals that quality is not being sacrificed in favor of ease. Remote services are equally or even more effective than in-person services in the treatment of depression, anxiety, substance abuse, post-traumatic stress, ADHD, and a variety of other disorders, studies are beginning to show.

At the same time, telebehavioral health offers “a pathway for organizations that want to develop more robust behavioral health programs but lack the staff to do so,” allowing them to expand their reach, says healthcare consultant Howard J. Gershon of New Heights Group in an article in Healthcare Executive. “People are learning that telesolutions in mental health services are readily available and work well. This shot in the arm will help us use these options to treat more people,” Gershon contends.

The widespread acceptance of virtual behavioral health

A recent survey by telehealth scheduling company Zocdoc found that both providers and patients see telehealth as a complement to, but not as a replacement for, in-person visits—except for mental health care. The steady increase in virtual visits for behavioral health care (from 74% in 2020 to 85% in 2021 to 87% in 2022, according to the survey) indicates that the option has gained a level of traction in the field that’s likely to last.

With telebehavioral health’s widespread acceptance, organizations that have not yet developed a telebehavioral health service may want to explore the feasibility of incorporating such a service into their virtual offerings. For organizations that already have telebehavioral care in place, now would be a good time to take a step back and revisit the program to optimize it and see how and where it fits in with their system’s larger long-term digital health strategy.

The 2022 Medicare Physician Fee Schedule lists telebehavioral health services that are permanently reimbursable as well as those that are covered only during the COVID-19 public health emergency.

Learn more about how Caregility’s enterprise telehealth platform can help support your organization’s mental or behavioral health program.

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