Not only are more individuals struggling with mental health issues today, but more people are willing to seek help.
As a result, mental health professionals as well as primary care and emergency departments are overwhelmed with the demand for behavioral health services — and are struggling to provide adequate and timely access. Digital tools can help.
In a featured session at a Becker's Hospital Review virtual event sponsored by Amwell, Lindsay Henderson, PsyD, director of psychological services at Amwell, and Jorge Palacios, MD, PhD, senior digital health scientist at SilverCloud Health, now part of Amwell, discussed the current mental healthcare crisis and the role that digital tools can play.
Four key takeaways were:
1. The country is facing a major mental health crisis. According to Dr. Henderson, health systems were already finding it difficult to connect patients with the right mental health providers before COVID. "That's only been worsened by the stress of the pandemic and other events across the last two years," she said. Data from www.nami.org shows that one in five American adults experience a mental illness during their lifetime. Dr. Henderson said there is a significant access problem, as current resources can serve only 40 percent of patients in the country. And, per data in Quartet Health, untreated behavioral health patients have far higher medical costs than patients receiving treatment.
As if the pandemic weren't bad enough, in an APA survey, inflation and the invasion of Ukraine are the highest rated stressors in the past 15 years and 73 percent of adults feel overwhelmed by the number of crises facing the world.
2. The pandemic raised baseline stress levels but increased awareness and acceptance of behavioral health assistance. Palacios explained that "the narrative in society is shifting." "People are more open to reaching out for help. I think the isolation that resulted from the pandemic kind of opened up wounds that may have been hidden by our daily lives." Dr. Henderson said patients want to "move forward in a meaningful way. One thing the pandemic did was make it much more acceptable to talk about mental health."
3. Digital tools designed to support mental health must be based on evidence-based research. Although a wide range of mental health apps have entered the market, most are not backed by scientific research. "This is potentially harmful because if you're someone with a mental health problem, you need help," Dr. Palacios said. "If you try these apps that have no evidence behind them, you're not only possibly getting worse, but you're wasting time."
Dr. Palacios shared how Amwell prioritizes research, highlighting several studies that show the clinically validity of internet-based cognitive behavioral health therapy (iCBT) for improving outcomes and even predicting treatment effectiveness. "We rely on a strong external partnership with a health center in England that recruited patients in real-world settings," he said. "The results of a large RCT we ran were published in Nature Digital Medicine and essentially showed that patients' symptoms of depression and anxiety significantly improved after treatment completion on our iCBT platform, and the symptoms kept going down across a 12 month follow-up [1]. We have published also on how recovery from depression and anxiety was maintained over time and in line with face to face therapy. [2]"
4. Digital tools support therapists and improve behavioral health access in ERs. Henderson pointed out that evidence-based digital tools can support clinicians by making in-person sessions more efficient and effective. "Digital products can lay the groundwork for talk therapy, helping to deliver educational information in a consistent way," she said. "Essentially your first in-person session can really be session three or four."
Digital tools can also be used to help put patients on the right pathways and to support them in their journey. In addition, digital tools, such as those used at the Cleveland Clinic Indian River Hospital, can help improve and expedite care delivery. At Cleveland Clinic Indian River, time to consult for psychiatry visits was reduced from 24 hours to less than 30 minutes following the implementation of its program and the number of telepsych consults doubled in one year.
By implementing digital tools backed with evidence-based research, healthcare organizations can improve mental health services, expand access, improve patients' mental health and better support overworked clinical staff.
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References
[1] Richards, D., Enrique, A., Eilert, N., Franklin, M., Palacios, J., Duffy, D., Earley, C., Chapman, J., Jell, G., Sollesse, S., Timulak, L. (2020). A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety. npj Digital Medicine. 3, 85. https://doi.org/10.1038/s41746-020-0293-8 Link to Paper
[2] Palacios, J., Enrique, A., Mooney, O., Farrell, S., Earley, C., Duffy, D., Eilert, N., Timulak, L., Richards, D. (2022). Durability of treatment effects following internet-delivered cognitive behavioral therapy for depression and anxiety delivered within a routine care setting. Clinical Psychology & Psychotherapy. Link to Paper.