By Ken Cahill, CEO SilverCloud Health
2019 will bring new approaches to breaking down the barriers that have historically prevented patients from accessing mental health services. Even with the traditional societal stigma given to mental illness sufferers, treating one’s condition is becoming a more mainstream practice with a greater number of people acknowledging their illness and feeling comfortable seeking care. However, obstacles within the health system continue to create roadblocks around getting the treatment needed.
Let’s begin with mental health care measurements and outcomes. While federal and state standards of mental health care are established, the current process by which therapies are validated is often variable. This dissimilarity is across the levels of scientific evidence as well as types of studies and outcome measures that are used to determine what constitutes an effective treatment, the necessary dose and duration of a treatment, and coverage for a treatment. As a result, consumers and payers are skeptical of the quality of the services they are receiving. Developing evidence-based standards will help ensure quality care for patients.
Another added problem is the growing shortage of doctors. Today, approximately one in five adults, or about 44 million people, suffer from mental illness in the United States, and this number is expected to increase in the years ahead. With the growing shortage of mental health providers and resources to treat these individuals, the gap between demand and availability will only continue to grow.
A report published by the National Council for Behavioral Health estimates that the shortage will be between 6,100 and 15,600 for psychiatrists alone by 2025. This creates an enormous strain across the entire health care system, most notably for emergency departments, primary care physicians, and underserved rural areas who are most directly impacted by the treatment gap.
The Misuse of Healthcare Resources
There has been a reported 42 percent increase in patients visiting the hospital emergency department (ED) to receive psychiatric treatment over a three-year period. But once they arrive, in many instances there is often no one on staff qualified or equipped to treat their conditions.
Lengthy delays in treatment are also common as patients are often left waiting for follow-up psychiatric services, averaging up to 23 hours for some conditions. In other instances, individuals are required to wait for days—even weeks. Compounding this problem is the impact extended ED wait times can have on care access for acute medical cases across the entire department, while also leading to poorer outcomes for psychiatric patients.
Additionally, primary care doctors are affected by the gap in available mental health services and support. While these providers can often serve as a gateway for patients with behavioral health conditions, appropriate resources to deliver treatment are not always available. According to Health Affairs, two out three primary care physicians reported difficulty referring patients for mental health care—more than twice the number reported for any other specialty.
Location Matters
Patients in rural areas, where one in five Americans live, have always had more difficulty accessing quality health care—and finding the right mental health resources is an even bigger challenge in many instances. More than 6.5 million rural Americans have some type of mental illness. However, a study published in the American Journal of Preventive Medicine revealed that 65 percent of rural counties don’t even have a psychiatrist, 47 percent don’t have a psychologist, and 81 percent don’t have a psychiatric nurse practitioner. Some states, such as Alabama, have a 1 to 260 clinician-to-patient ratio. Without access to the appropriate resources, it is almost impossible to include mental health services as part of a preventative care plan.
The Mental Health Technology Delivery Model is Broken, but Technology Can Help Fix It
The traditional model of psychiatric care delivery is broken, but with acknowledgement of this issue also comes fresh opportunity for change. In 2019, the industry will see an increased awareness of how digital care solutions can successfully alter the way that mental health resources are being delivered. This includes digital health tools built to tackle barriers to mental health resources head-on, including a lack of clinical resources, limitations to transportation, privacy issues and societal stigma concerns. Receiving growing industry recognition, these innovative new technologies will expand access while providing effective, reachable, and affordable mental health resources.
For example, online mental health platforms have the potential to create a huge impact on the way that resources are optimized, while costs are reduced and better outcomes are achieved. When it comes to care delivery triage, digital platforms could automate the process, allowing providers to focus resources on the patients that require face-to-face treatment. These tools are also poised to play a valuable role in improving early assessment and intervention for patients at risk, potentially speeding up access to necessary treatment resources.
In addition, the data that these technologies provide allow for expanded intelligence, enabling a class of evidence-based programs that center around scientific knowledge, clinical expertise and experience. As these offerings mature, they will be increasingly valued by both payors and providers due to their potential to shrink an alarming gap between the critical need for comprehensive mental health services and the resources that are available to patients today. An improved patient experience should be anticipated, especially among the high-cost behavioral health populations and rural communities that have a harder time accessing such care.
Furthermore, throughout the coming year, mental health solutions will become more tailored to the individual patient as artificial intelligence and advanced machine learning are increasingly utilized. Some online platforms are already leveraging these next generation capabilities to aggregate real-time patient infromation (related to program use/engagement/experience and ultimately outcomes) to continuously improve the individualized program offering. Having these advanced digital tools available has made almost real-time outcome data and patient feedback possible, which has the potential to fundamentally change mental health treatment delivery as we know it today.
About the author
Ken comes from an entrepreneurial background, having previously worked for several large multinational organisations. Under his direction, SilverCloud Health has revolutionised how technology is used to address some of the key challenges in healthcare.
