The role of telepsychiatry in managing mental illness as an adult
An uptick in demand for mental and behavioral health services has garnered the attention of national regulatory and advocacy groups in recent years as concerns over access to care and rising costs move to the forefront. It’s one reason that direct-to-consumer (D2C) telepsychiatry is emerging as an important part of the solution.
Through use of videoconferencing technology, D2C telepsychiatry provides an anytime, anywhere framework to gain access to mental and behavioral health care. Individuals use an Internet-enabled computer or mobile device to engage with remote psychiatrists and other behavioral health professionals from a location that’s convenient for them. This is especially important for individuals that have difficultly leaving their homes due to various reasons, including, but not limited to, panic disorder, agoraphobia or those with severe autism spectrum disorder who may benefit from seeing a provider from a home environment.
Access to mental and behavioral health care is problematic, with many individuals facing months-long waitlists for their first appointment. According to the National Institute of Mental Health (NIMH), approximately 50 percent of chronic mental health conditions begin by age 14 and 75 percent begin by age 24. At the same time, the delay between when symptoms first appear and when intervention occurs is eight to 10 years on average, meaning many individuals are well into their adult-life before they receive treatment for issues that may have occurred for years. D2C telepsychiatry improves the outlook by enabling earlier interventions through better care access, ultimately decreasing the decade-long latency period often seen before treatment is started.
Access challenges
The U.S. Department of Health and Human Services reports that 22 percent of people over the age of 55 and two-thirds of nursing home resident suffer from behavioral health issues. Yet, less than 3 percent of older adults receive services for their illness.
In terms of access to services, industry data underscores a significant supply and demand challenge for mental and behavioral health care in all U.S. states, and severe professional shortages exist in geriatric specialties. Unfortunately, the availability of specialists in this space will continue to remain scarce as less than 1 percent of doctoral students and 2 percent of practicing psychologists are connected with geriatric specializations.
Looking ahead, traditional behavioral health access models alone will not be sustainable to meet growing needs. Consequently, the need for telemedicine models that provide a convenient avenue for patients of all ages to engage with providers across geographies and institutions will continue to increase.
Factors contributing to growing adult behavioral health needs
The population of adults between the ages of 53 and 71—also referred to as Baby Boomers—is known for its sizeable presence when compared to other generations. Growing numbers of aging adults naturally lead to greater health care needs, including mental and behavioral health.
Depression is the most prevalent behavioral health diagnosis in adults, and the rate of older adults exhibiting depressive symptoms increases with age, according to statistics from the Centers for Disease Control and Prevention. While 80 percent of people with depression could benefit from treatment, these disorders are frequently overlooked and go untreated in older adults as they coexist with other disorders, illnesses or even major life events, such as loss of a loved one.
Other factors contribute to late-stage behavioral health diagnoses. For instance, the APA reports that gender bias is a common occurrence in behavioral health, resulting in many adult women facing late-stage diagnosis of ADHD and other similar disorders or conditions.
Individuals who experience a mental or behavioral health diagnosis as an adult not only need access to professionals to help them make life adjustments and learn how to cope with their condition, but also options that offer the added flexibility needed to fit within their existing lifestyle. Otherwise, negative downstream implications can impact families, workplaces, long-term care facilities and communities at large.
Taking Hold of the D2C Telepsychiatry Opportunity
The anytime, anywhere framework of D2C telepsychiatry enables more proactive treatment of adult conditions, resulting in better outcomes and lower costs. One literature review, for instance, found the use of video conferencing models expedited access to care, decreased work absences, enhanced confidentiality and privacy, empowered patients in their care and reduced the risk of hospitalization. These benefits extend across many adult life scenarios, including:
Today’s working professional. Many adults who receive a behavioral health diagnosis later in life are still active in the workforce, making it particularly difficult to schedule appointments or attend therapy sessions during “traditional” office hours. Stigma is another overarching concern in today’s workforce, and employers and employees may hesitate to seek support when such issues surface. The heightened privacy afforded by telepsychiatry improves the outlook as individuals no longer need to worry about running into colleagues in a waiting area or outside a facility. D2C telepsychiatry also improves the likelihood that adults will seek out and receive consistent care due to convenient, flexible scheduling options that allow appointments outside of typical weekday time slots.
Stay-at-home parents. Receiving mental and behavioral health care for stay-at-home mothers and fathers can also be challenging amid busy children’s schedules and home-life responsibilities. Plus, finding sitters requires extra expense and time. D2C telepsychiatry helps overcome these challenges by offering appointments from the convenience of an individual’s own home, eliminating the need to travel to providers, and during nights and weekends. Access requires only a reliable Internet connection, a computer, tablet or smartphone with a webcam, and a private space.
Later in life. D2C telepsychiatry also promotes expanded access to geriatric specialties when needed. Long-term care facilities that are in remote regions with severe provider shortages are afforded options outside of their local geography via a teleconference model. D2C telepsychiatry is also uniquely suited for aging-in-place trends, allowing seniors who might otherwise be unable to get to appointments to access services in their homes. As seniors often rely on care givers or other support in their day-to-day life, traveling outside the home environment can be considerably difficult, making remote care options ideal.
As behavioral health needs continue to soar and outpace the supply of available professionals, children, adults of all ages are wise to consider telepsychiatry as a vehicle for improving their care and taking more control of their health. D2C telepsychiatry is clinically proven to deliver high-quality care that meets the standard of traditional in-person care for diagnostic accuracy, treatment and patient satisfaction, and offers a tremendous opportunity for improving access to care throughout the continuum.
By Michael Lee, DO, psychiatrist for Inpathy, the direct-to-consumer division of InSight Telepsychiatry