By any standards, the burden of mental illness in this country was significant before the pandemic began. It was the leading cause of disability, and added greatly to costs related to medical care for other conditions. Mostly, it has been a leading cause of suffering.
Then the pandemic hit. Data shows higher rates of depression, anxiety and substance use disorders, which is not surprising given how hard the pandemic has been for so many of us.
But this dark period has a couple of silver linings. The first is a general lessening of stigma associated with mental illness and substance use disorder, which has historically prevented so many people from getting help. Since these conditions have become so prevalent and openly discussed, many people are now able to recognize and confront them in a more straightforward fashion and to seek care more easily. But as with other impacts of the pandemic, the lessening of tis stigma can vary greatly by demographics.
The second silver lining is that the pandemic has, by necessity, made many people more familiar – and comfortable – with receiving care via virtual channels. Virtual behavioral health existed before the pandemic but was little used, even though it works very well. Patient-provider interactions are typically conversational and ongoing, and virtual visits can be easier to schedule around the patient’s work and home responsibilities, which supports sustained engagement with courses of treatment.
Care delivery, check-ins and coaching can be delivered by phone, video or text. This can help with provider responsiveness and meet the personal preferences of the patient. Care models that integrate peer support and educational elements are well suited to a virtual care environment.
While virtual behavioral health care offers a number of advantages, it is still clinical care provided by professionals and is subject to the same limitations as more traditional care delivery models. First and foremost is the need to address the quality of care that is being delivered: It is important to measure clinical impact and not just net promoter scores. Secondly, virtual care vendors face the same shortages in qualified behavioral health professionals that traditional providers do. Specialists in pediatric behavioral health are in especially short supply.
Looking ahead, it seems virtual care is here to stay. It will still be important, however to retain face to face experiences and with continued expansion of digital care, clinically sound applications may be a means for some to receive support. Keeping many doors open for people to enter that suits their needs and comfort is key.
Our hope for the future of behavioral health care is that it becomes an integrated, everyday part of health care in general – that identifying and treating these conditions will be seen as no different than addressing a sprained ankle or high blood pressure. We also hope that as we look to leave the pandemic experience behind that we do not underestimate the difficult and profound impact this has had on so many of us and that we will be able to support the long process of getting people back on their feet.