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Leveraging Telehealth To Improve Access To Mental Healthcare


David Mou, CEO, Cerebral.

The healthcare system has reached a crisis point; millions of Americans who suffer from mental illnesses can’t find care. According to the National Institute of Mental Health, an estimated one in five adults suffer from a mental illness, and more than half do not receive treatment.

Our mental health system is failing Americans. As a psychiatrist, I’ve seen patients wait months before their first appointments. More than half of U.S. counties have exactly zero psychiatrists. This is unacceptable. But there’s a promising solution in telehealth. Unlike other medical specialties where in-person physical exams are critical, psychiatry uniquely depends more on building trusted relationships that can lend itself to this form of remote healthcare.

Barriers To Reaching Mental Health Patients

I find that stigma serves as a major barrier for those seeking mental healthcare. Many do not feel comfortable sharing their struggles with their family members or friends. Some of my former patients went to extraordinary lengths to hide from their loved ones the fact that they were seeking mental healthcare. Overcoming this culturally-ingrained stigma should not have to be a prerequisite for receiving care.

Convenience is another barrier those in the industry need to consider. Taking an afternoon off every week to attend in-person therapy sessions is a luxury that most people cannot afford. The National Council for Mental Wellbeing reports that nearly half of Americans know someone who has had to drive more than an hour round trip to seek mental health treatment.

Lastly, the match between clinicians and patients is particularly important in mental health. The more clinicians to choose from, the better patients can find clinicians who fit what they are looking for.

Three Areas Of Focus For The Industry

Taken together, these barriers illustrate why mental health clinicians need to meet patients where they are, not the other way around. Telehealth in mental health is just getting started. What do we need to do in order to get to telehealth 2.0? Here are three areas where the industry should focus.

1. Historically Underserved Communities

Telehealth can be leveraged to help those who have been historically disenfranchised, which includes those who are geographically outside the reach of clinicians, as well as those who are culturally disenfranchised; many ethnicities are particularly averse to the idea of mental healthcare. As a Chinese-American, I have witnessed this first-hand.

Telehealth providers should prioritize hiring a diverse group of clinicians who can understand cultural contexts and the unique challenges facing any given individual. Furthermore, marketing campaigns should be tailored in a manner that is culturally sensitive and accessible.

Lastly, telehealth solutions can serve as a first option for care, but should patients require an escalation in services, telehealth providers should be able to refer them to in-person care as needed. Brick-and-mortar clinics, hospitals and telehealth providers should partner to create an integrated experience that puts the patient at the center. The future of care will allow patients to move seamlessly between different levels of care.

2. Outcome-Based Measurements

Shockingly, the vast majority of mental health professionals do not measure clinical outcomes. A survey in 2015 showed that a large percentage of psychiatrists do not even use electronic medical records. Without data on how patients are doing, clinicians will have trouble knowing which of their patients needs their attention.

Lessons from telehealth practices can help address many of these issues. Given that telehealth platforms are built on newer technology platforms, important clinical measures are more easily monitored. Depression scores, compliance with medications and other data empower clinicians to adjust their treatment plans accordingly so that patients can get better, faster.

For example, you can determine which patients have not completed their labs and remind clinicians to get in touch with those patients to ensure that the labs are completed. You can scan patients’ messages for suicidal content using machine learning and proactively reach out to those patients within minutes. This is just the beginning of how data can be leveraged to improve care.

3. Affordability

Cost is a major obstacle to care. Millions of Americans struggle to find a mental health care professional who takes their insurance. Studies show that the acceptance rate for all forms of insurance is significantly lower for psychiatrists than for physicians in other specialties. Many psychiatrists hesitate to take insurance given the low pay, burdensome logistics and delays in payment.

They are often wary of taking on the toughest cases; it’s a shameful fact, but I’ve seen many psychiatrists actively avoid taking on patients with suicidal thoughts. Why take on a high-risk patient when you get paid the same for taking on a mildly depressed patient? Our most vulnerable patients end up having the hardest time seeking care. This is unconscionable. Including these patients is not only the moral thing to do, but it helps improve the reputation of our industry.

Utilizing Data

Using data, there’s a unique opportunity to drive a virtuous cycle that can benefit clinicians, payers and, most importantly, patients and their families. Data can demonstrate how providers can improve the quality of care while reducing costs (e.g., preventing unnecessary emergency room visits). This, in turn, allows health insurance companies to better identify the best clinicians and pay them more. I believe this will lead to clinicians becoming increasingly open to taking on insurance-based patients, given that their compensation will be tied to performance. As a result, more patients can get care.

As medical professionals, we have to do a better job of meeting patients where they are physically, culturally and emotionally. I believe that telehealth is a key part of the solution. For example, most of the patients my company has helped have never received mental health care before.

The future of mental healthcare should allow patients to seamlessly transition between all levels of care: app-based, telehealth, in-person, urgent care and inpatient care. New technology and systems are opening doors and have the potential to improve the lives of millions of Americans who have been underserved for too long.


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