How telehealth reduces barriers to mental health treatment: American Well psychological services director

Lindsay Henderson, PsyD, director of psychological services at American Well, discusses how telehealth can help break down barriers to mental health treatment and its impact on the patient-provider relationship.

Dr. Henderson is a clinical psychologist and oversees psychological services at telehealth provider American Well. Prior to joining the virtual care platform, Dr. Henderson worked as a staff psychologist within Belmont, Mass.-based McLean Hospital's child and adolescent divisions. She also has experience as a clinical instructor at Harvard Medical School in Boston.

Here, Dr. Henderson shares her initial experience getting into telehealth and how virtual care helps improve patients' access to mental health services.

Editor's Note: Responses have been lightly edited for clarity and length.

Question: What are some issues surrounding mental health treatment that telehealth can help solve?

Dr. Lindsay Henderson: Mental health treatment can be difficult to access but telehealth can help reduce some of these barriers. The need for mental health services today is increasing and there aren't enough providers to handle the demand. Additionally, in some more rural parts of the country, mental health providers may not be readily accessible. As a result, patients often must wait weeks or months before they can get an appointment or travel great distances to see a mental health provider, which can be disruptive. Telehealth can break down geographical barriers and enable patients to see a provider, sometimes in just a matter of hours, reducing wait times and providing access to care when it's needed most.

There's also a stigma that exists around mental health causing many people who are suffering to be uncomfortable or too embarrassed to seek help. By seeing a provider virtually, patients can get care from their own home or wherever they are most comfortable. This removes the chance that they'll run into someone they know in the waiting room for instance. Being in a natural environment can also help patients feel more comfortable opening up.

Q: How has telehealth impacted your workflow as a mental health provider?

LH: I'm able to see more patients in less time while providing better care. Telehealth has enabled me to integrate providing good mental healthcare into my life more seamlessly and more effectively, which makes me a better provider for my patients while giving me a higher quality of life.

I came to telehealth when I had my first child. I now have two toddlers and I'm able to balance a full career with being a parent to young kids. I can fit more work into my day and in less time, so I experience less burnout. The flexibility of telehealth is particularly helpful as a therapist, when appointments are 45-plus minutes in length and one or two no shows or cancellations is very disruptive because you only see eight or so patients per day.

Q: In what ways does telehealth impact the patient-professional relationship?

LH: In many ways, telehealth can strengthen the patient-provider relationship. While there are benefits that can come with being able to see a patient in person, virtual consults can give providers more insight into a person's typical environment and normal activities, especially during times of need. Telehealth also gives providers an opportunity to get more insight into a patient's life than traditional in-person settings, which can also help strengthen the bond.

There are nuances to consider when providing care virtually that when done right will help build trust and ensure a strong patient-provider relationship. As providers, it's important to give patients a tour of the room you are in to show that you are in a private place. Because there might be limitations to what patients can see based on the device they are using, providers should also make sure to tell patients what they are doing if it's going to be off-camera, for example when taking notes.

Q: How do you think telehealth usage will continue to evolve in mental healthcare in the next few years?

LH: We can already treat almost anything online — a common misconception as many people don't think they can receive care for as many conditions virtually. At American Well, we're seeing some of our clients implement behavioral health programs via telehealth in school settings, with children being a population where we see mental health issues growing. School-based programs can help kids get care without leaving their school, while reducing the burden on school counselors who may be responsible for hundreds of students. We're also starting to see an uptick in substance abuse programs that are offered through telehealth. With more insurers offering telehealth as a benefit, we can expect the number of behavioral health programs offered virtually to increase.

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