COVID-19, Telemedicine and Mental Health

Locked-down America has been converted to a country gravely in need of virtual therapy amidst the recent Coronavirus crisis. During these trying times, telemedicine has emerged as a viable solution to help connect people with health professionals.

While the healthcare industry works to mark the issues that put a stop to comprehensive and widespread behavioural health services, many providers are looking to optimise access to quality health care by leveraging telemedicine. 

Mental health isn't a one-time, simple fix. It is a complex process that includes behavioural health, moving past the stigma so people feel satisfied seeking care, and the converging of numerous experts and stakeholders to evolve new ways to convey that care.

While the novel Coronavirus continues to wreak havoc on healthcare systems around the world, a new poll, published on April 2 reveals the psychological toll the pandemic is taking on the average American. According to the survey, 45% of adults say the pandemic has had an impact on their mental health, while close to 19% say it has had a "major impact."

“What we're really seeing is a global experience of anxiety, and how that’s impacting our day-to-day lives,” explains Kelli Finley, Executive Director of the National Alliance on Mental Illness (NAMI) in Marin County, just north of San Francisco in a recent interview. Although getting past the pandemic is truly testing, Finley alerts that the real psychological consequences of the catastrophe may not emerge in people until after the pandemic has receded. 

“Mental health issues often appear after the crisis, not during,” she says, indicating at the 2019 wildfires in California that caused widespread evacuations, burned close to 77,000 acres of land, and cut off power to over a million Californians.“During the fires, people rallied to man the shelters, gather blankets, and perform other specific tasks to get through the crisis,” she says. “It’s when people got back to their normal lives that we saw an increase in mental health issues and even PTSD.”

She expects that the elderly people, first-line responders, and teens, who are experiencing rising levels of depression and anxiety, will be the ones impacted to the greatest degree by a post-traumatic stress response to the COVID-19 situation. 

In a recently released recorded announcement, Headspace co-founder Andy Puddicombe is seen suggesting people to not disregard their mental health amidst these highly uncertain times. “It’s difficult to even know where to begin to address the extraordinary stress, anxiety and trauma that individuals and communities are experiencing,” Puddicombe said. “Now more than ever, it’s essential to look after our physical and mental health, both for our own benefit, and for those around us.” 

With nearly a third of the globe’s population on some form of coronavirus lockdown, lengthy periods of “social distancing” and isolation are making way to increased feelings of depression, anxiety, and stress. For some people, the anxiety comes from a fear of having their loved ones become ill or getting sick themselves, while for others, it’s the fear of unemployment, or having already lost a job, or having to face the economic downturn. For the majority, however, it’s the uncertainty of how long this isolated, unusual lifestyle will persist. 

Several studies — including two published in the Cyberpsychology, Behavior and Networking and the Journal of Affective Disorders — found online counselling to be as effective, if not more, as conventional face-to-face therapy.

A University of Zurich study, published in the Journal of Affective Disorders (2013), split a group of 62 patients in half and concluded that depression was alleviated in 53% of those given virtual therapy, in comparison to 50% of the ones who went through in-person counselling. Three months following the completion of the study, 57% of the virtual therapy patients showed no signs of depression compared to 42% with in-person therapy.

Additionally, a four-year Johns Hopkins study that included close to 100,000 veterans found the number of days patients were hospitalised dropped by approximately 25% when they chose online counseling. This is moderately higher than the number of hospital visits experienced by patients who used conventional face-to-face counselling (Psychiatric Services, April 2012).

For patients and providers alike, in addition to the constructive health effects, there are several other benefits to telemedicine programs. A few of these include:

According to a global Cisco survey, 74% of the total number of patients preferred easy access to healthcare services over in-person interactions with providers. Amidst the global COVID-19 pandemic too, convenience happens to be the key since patients won’t prefer exposing themselves to the virus by stepping outside their house to see a mental health specialist. Adding virtual care to your practice offers patients easy, on-demand care – without having to step out of their comfort zone. Patients who are bedridden can also access this form of mental care easily. Video conferencing, smartphone apps, and online management systems are some avenues healthcare providers should consider to connect with more patients right now.

With telemedicine, patients in rural or remote areas can benefit from more convenient and quicker mental health specialist access.In the U.S., for every 100,000 rural patients, there are only 43 specialists available under normal circumstances. These patients endure longer appointment commutes due to lack of resources and have trouble accessing lifesaving consultations for specific diseases or chronic care plans. Telemedicine can offer better access to more mental health specialists, especially during these testing times when people are going to need them more than ever before. Remotely located patients can now connect with the mental health specialist of their choice, through their local hospitals which are easily accessible to them.

If you’re a mental healthcare provider, you wouldn’t disagree with the fact that when patients are committed to their own healthcare goals, it leads to improved health within a considerably shorter span of time. Engaging your patients through telemedicine, especially during a pandemic like the one we’re facing right now, can help them maintain care schedules and appointments. Increased engagement initiatives can also curb feelings of loneliness and not being able to talk to anyone amidst these testing times when one can easily get drifted toward harmful lifestyle choices.Not only do virtual visits reassure patients that their providers are available and involved in their care, it makes it much easier for them to report early warning signs, reach out with questions, and make a follow-up appointment to ensure they’re right on track.

Several healthcare experts are of the opinion that the pandemic will get more patients and providers together and make them comfortable with the use of telemedicine for behavioural care, even after the disruption to daily life ends. Some telehealth advocates say a further embrace of this technology can prove to be an invaluable tool, giving providers deeper insight into their patients’ holistic well-being. For now, it looks like the crisis could be a tipping point for the way the world connects with behavioural healthcare providers across the globe.

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