Even before the pandemic, nearly one out of five American adults and one in five children and teens suffered from a mental health condition, from anxiety to depression to suicidal ideation. What compounds this crisis is the lack of behavioral health providers available to meet people’s mental health needs. By 2024, the United States will face a shortage of up to 31,091 psychiatrists, and psychologists, social workers and counselors are in high demand—and overextended. Technology has the power to mitigate today’s behavioral health crisis on a global scale.
Here, we talk with Ken Cahill, Chief Behavioral Health Officer at Amwell, about the benefits technology brings and how it can be used to support the full spectrum of behavioral health care needs for patients.
Q: How do we use technology to ensure people are getting the right level of care at the right time?
It started with virtual visit access to behavioral health providers, where individuals could meet with a therapist from the comfort of home or, in some instances, in a private area of a primary care physician’s office or community service center – wherever they are most comfortable. Advancements in digital behavioral health give people expanded access to comprehensive behavioral services that are personalized to each person’s unique needs. Patients can be referred for digital therapy or can initiate services on their own, and their services can span the continuum of behavioral health care, from low-acuity services such as digital mental health coaching to longitudinal therapy to psychiatric services and medication management.
Q: How does digital mental health work and what capabilities are critical to its effectiveness?
Digital mental health services work by using a combination of interactive tools, videos, engaging content—including user stories—and access to asynchronous coaching or live support from behavioral health professionals to help people think and feel better. The best digital mental health services are those that are evidence-based and highly personalized—with proven results. Additional capabilities that are necessary for success include the ability to deliver tech-enabled care at scale across a population and via a variety of devices. Patients should be able to easily access and navigate services from their smartphone or mobile device as well as a laptop or personal computer without experiencing diminished quality from one device to another.
Q: If a patient using a digital mental health tool requires escalated care, how do we ensure that patient doesn’t end up in the emergency room?
Ken Cahill: Through live interactions, trained physicians and therapists can effectively determine the appropriate next steps for the patient depending on their needs. They can determine how to connect the patient with the best in-person support and the right setting for care depending on their acuity level. This not only ensures that patients receive clinically appropriate care, but also helps avoid scenarios where patients end up in the emergency department
Q: How can technology help patients that do end up in the ED for psychiatric conditions?
Ken Cahill: When a patient who is facing a mental health crisis comes to the ED for care, virtual technology can give ED physicians direct guidance from a licensed psychiatrist. It also gives psychiatrists a real-time look at how the patient is responding and, provides an opportunity for them to speak directly with a patient. Behavioral health consults in the ED give ED physicians the basis for informed care. Digital technologies can also speed access to specialty care support. The impact can be substantial. At Cleveland Clinic Indian River Hospital in Vero Beach, Fla., virtual behavioral health consults decreased the time it takes to receive ED psychiatry consultations from 24 hours to less than 30 minutes. At CommonSpirit Health, telepsychiatry consults in the ED reduced response time to 42 minutes, with 61% of patients seen within 30 minutes and 79% seen within 60 minutes.
Q: What’s a scenario in which all these technologies come together to provide full-spectrum mental health with in-person care to deliver true value for the patient?
Ken Cahill: A teenager who is suffering from suicidal ideation is brought to the ED by her parents around midnight. The ED physician consults with a psychiatrist via virtual technology and works with the psychiatrist to stabilize the patient and assess her condition. Before the teenager is discharged, she is enrolled in a virtual follow-up appointment with a psychiatrist for the following afternoon. In between virtual appointments, the patient uses her smartphone to access tools for self-guided therapy, with connections to live support, when needed, based on data and the patient’s preferences. Through a digital platform, the teenager’s parents, her primary care physician, and her behavioral health provider are kept apprised of her progress. This approach ensures the patient receives the right care at the right time and in the right setting for as long as she needs it.
Q: Why is now the time to act and what’s the first step to take action?
Ken Cahill:The shortage of behavioral health specialists is getting worse, not better—and so is the proportion of people who need mental health services. Given that more than half of U.S. counties do not have a psychiatrist and shortages of psychologists, therapists and social workers also present barriers to care, adoption of digital technologies is key to helping to solve the U.S. behavioral health crisis. To adopt a more comprehensive, tech-enabled approach to behavioral health, identify your organization’s pain points and the needs of your community. Then, look for technology partners that can help you tackle these challenges in tightly integrated and highly seamless ways. The right partnership for tech-based behavioral health support could substantially improve the mental health status of the communities you serve, now and in the future.