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In virtually every facet of the healthcare system, patient care is constantly evolving, and providers must follow suit by adapting to the changing times. Improved patient care is based on a wide range of factors from technological advancements to public opinion, governmental policies and regulations, and behavioral dynamics.
Another factor at play in the decision-making process is among patients practitioners and policymakers alike. Healthcare is a deeply personal arena, and numerous social demographics can profoundly impact a community’s awareness of and access to innovative medical technology such as telehealth. Whether for physical or mental healthcare, telehealth technology has typically been utilized in areas with limited healthcare access, including rural communities.
Today, in a world forever altered by the lasting effects of a global pandemic, the picture of telehealth looks much different.
How Telehealth Can Improve Patient Care
Although telehealth is effectively in its prime thanks to the global need for social distancing, the adoption of this technology has seen a relatively slow start. As of 2019, for example, fewer than 10% of patients used telehealth services in any capacity, whether for the treatment of mental health disorders or a physical condition. At the time, providers cited lack of awareness as the primary reason for low adoption numbers. Put simply, the bulk of patients weren’t even aware that telehealth services were an option in 2019, or that they could reach out to a mental health professional without leaving the house.
That fact should come to as little surprise to providers, however, considering that, as a medical niche, mental health enjoys a sort of second-tier status that doesn’t reflect the prevalence of mental health issues in the U.S. and around the world. Studies indicate that around 40% of U.S. adults have experienced a negative health event since the beginning of the pandemic, chiefly anxiety and depressive disorders. However, only a small percentage of those individuals seek treatment for their conditions, with economic factors of particular note in this regard.
Further, certain populations boast an increased risk of developing lasting mental health conditions and/or substance use disorders, which are often co-occurring conditions that can quickly cause a patient to spiral out of control. Those most at risk of developing pandemic-related mental health symptoms include young people, communities of color, essential workers, and those experiencing economic hardships.
As such, it is these individuals who may reap the greatest dividends from expanded telehealth services. Of course, in addition to access, patients are more likely to respond to mental health treatment if they trust their provider. Using empathy, psychiatric mental health nurse practitioners (PMHNPs) and other mental health professionals are better equipped to develop a strong relationships with their patients. When communicating with patients, in person or online, it’s important for providers to make eye contact, and be mindful of nonverbal cues and body language. Further, as effective mental health care often hinges on access, providers must be willing to compromise and alter their patient care model in order to accommodate high-risk patients.
Legal Factors at Play
Interestingly, the COVID-19 pandemic that’s fueling the rise in telehealth has also helped open doors for those mental health professionals previously held up by stringent licensing requirements and parity laws. Prior to the COVID pandemic, in fact, just five states had telehealth parity laws in place: Minnesota, Hawaii, New Mexico, Georgia, and Delaware, reports The Commonwealth Fund. Under telehealth parity laws, providers are guaranteed reimbursement at the same rate whether they provide in-person or remote care.
Currently, there is no federal statute that requires payers to cover telehealth in any capacity. However, 21 additional states have expanded their telehealth services since 2020, in response to COVID-19 emergency orders. Among its myriad benefits, the expansion of telehealth services around the world has helped bridge noticeable gaps in the realm of mental health.
Telehealth parity laws notwithstanding, the U.S. mental healthcare system is significantly overtaxed. As such, many policymakers and medical professionals have been forced to make hard decisions, with potential long-term consequences.
Hyperbolic Discounting and the Rewards of Telehealth
When given the choice between a prolonged reward system or instant gratification, humans typically choose what they believe is the sure thing. This tendency to prioritize short-term gratification is known as hyperbolic discounting, and it can negatively impact our well-being over the long term.
When weighing the cost benefits of a particular policy or mandate, politicians also tend to take the hyperbolic discounting route. When it comes to parity laws around telehealth, the unfortunate reality is that many policymakers have yet to realize the benefits of this kind of technology, nor the long-term implications of a healthier global population.
The good news for providers looking to expand their reach is that empirical evidence supporting the efficacy of telemedicine in the treatment of mental health disorders is plentiful.
By developing a well-rounded understanding of the behavioral and social factors at play, mental health providers and legislators can work together to spread awareness of technological advancements that benefit patients over the long term. The healthcare industry isn’t one-size-fits-all, and for many patients, telehealth holds the key to improved wellbeing, of both body and mind.
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