A recent report by AMA evaluated the state of behavioral health in the United States, and the outlook seems grim. Living during a global pandemic only exacerbated the rising number of Americans with anxiety and depression, increasing from 1 in 10 adults in 2019 to nearly 4 in 10 by early 2021, according to the report. Additionally, suicide jumped to the second-leading cause of death for the 10-24 year old demographic. Better integration of behavioral with physical health seems the logical solution, the report stated. However, with the national provider shortage, offering such care proves easier said than done.
Digital tools could address behavioral health integration, though not with the intent to replace in-person care, according to the report. These digital tools ideally would act as a complement. For example, digital tools could help with screening patients and intake as well as clinical decision support. Further, telehealth care delivery could act as a complement to traditional care models. However, inequities in access to digital tools — such as insufficient internet bandwidth to sustain a telehealth video call — present a new set of problems that need addressing.
There are many efforts underway to tackle mental health, and in some cases, to integrate it with primary care. One of those is providing such care virtully. Boston-based Amwell has a digital platform to deliver behavioral healthcare online. Amwell’s digital platform offers on-demand mental and wellbeing health programs and optional human coaching, Lindsay Henderson, director of psychological services at Amwell, explained in an email. Henderson weighed in on the findings of the AMA report.
MedCity News: What is your take on the AMA report? What do you think are the most significant findings?
Lindsay Henderson: There has never been a better time to strengthen digital access to behavioral health, given the sharp rise in mental health conditions and a nationwide shortage of behavioral health specialists. Digital options for behavioral health—from telehealth to chatbots to digital therapies—hold strong potential to improve quality of care and health outcomes. The ideas presented in the AMA report offer a solid starting point for engaging multiple stakeholders in this effort. Now, we need to take them a step further, looking for ways to be truly innovative.
MedCity News: Can you give an example?
Henderson: To make a substantial difference, payers, providers, employers and the government must work together to design a value-based approach to digital behavioral healthcare. Such a model should emphasize the need for improved availability of mental health services—especially in areas where a lack of behavioral health providers exists. It should also address social determinants of health that make it difficult to receive mental health care.
MedCity News: What are the implications of the report?
Henderson: The report lays a foundation for collaborative efforts to develop digital behavioral health services at scale. It also serves as a conversation starter in communities where the need for an alternate approach to in-person behavioral health services is crucial.
MedCity News: What should future studies address and explore?
Henderson: I would like to see greater input from providers regarding their biggest barriers to digital behavioral health. I present guest lectures at a local graduate school, and what is alarming to me is the number of students I encounter who are about to graduate from their doctorate program and are already burned out. These students are already exhausted before they enter the behavioral health field, and that concerns me. Capturing their perspective is essential to developing digital health strategies that resonate with behavioral health professionals and their patients.
MedCity News: Are there limitations of the study?
Henderson: The strategies shared in the report would be stronger if they incorporated practical ways to encourage use of digital health as part of a value-based care delivery model. Ultimately, value-based reimbursement that emphasizes a well-rounded approach to behavioral care treatment and access—including digital tools for behavioral health services—will be key to furthering adoption of these tools.
MedCity News: What recommendations do you have for delivering behavioral healthcare virtually?
Henderson: Go beyond a point solution for behavioral health and ensure the experience is integrated with other therapeutic areas to enable whole person care. Mental and behavioral health are core components of total health.
MedCity News: What are your best practices at Amwell for delivering behavioral healthcare virtually?
Henderson: One best practice in delivering behavioral health services virtually is to meet patients where they are. This means delivering digital behavioral health in users’ preferred format during hours that best meet their needs. It also necessitates investment in digital tools that are proven to be as effective as face-to-face therapy.
Photo: Alisa Zahoruiko, Getty Images