The Virtual Band-Aid on America’s Behavioral Health Crisis
While it may seem like most of the world has put the pandemic in the rear-view mirror, a new kind of outbreak has emerged, exacerbated by the tumultuous last three years. Within the first year of the pandemic, anxiety and depression spiked by 25% globally, according to the World Health Organization. Furthermore, despite remaining relatively constant prior to the pandemic, the number of behavioral health visits increased by 18% in 2022 alone. Adding fuel to the fire, this drastic spike in demand has left the US healthcare system floundering, revealing the dire need for adequate resources and attention devoted to behavioral health support. The Kaiser Family Foundation reported that, in 2022, 47% of the US population lived in areas underserved in the mental health space and, while almost a quarter of US adults have been diagnosed with a mental illness, only 19% reported having received treatment, with significantly lower rates among black and non-Hispanic white populations. In the face of this demand, supply has remained stagnant for doctoral level psychologists, and the number of practicing psychiatrists has decreased since the pandemic’s inception, outlining a concerning trend.
Importantly, however, the development and adoption of digital support services has increased alongside America’s growing mental health crisis. The past three years have ushered in novel digital health services, bringing more accessible and cost-effective care to patients. Yet the solution has proved to be far from the miracle that the sector direly needs. While telehealth may increase access to care among underserved communities, these novel care models still fail to address the key issue in behavioral health support: supply. Whether an established health system or a new digital health model, the finite and dwindling number of behavioral health professionals persists. As more and more psychiatrists retire and residency programs fail to meet the gap in an aging workforce, digital health services too are feeling the pressure of inadequate supply.
To make matters worse, while the emergence of digital solutions promised to make behavioral healthcare readily available, additional shortcomings have come to light in recent years. Many patient needs are not well suited for virtual care, including those who need specialized therapeutic treatments. Others who do not have the devices or internet required for digital services are also neglected by these novel virtual solutions. So, while America may have gone all in with its adoption of a system that promises to fix behavioral health from an access perspective, it is abundantly clear that telehealth cannot serve as the sole solution for a crisis that continues to grow.
With new policy initiatives on the horizon, the disparity between the demand that is met and that which is left untreated is only set to widen. Policies such as the US Preventive Task Force’s recommendation to screen all children and adults for anxiety and depression are projected to further increase case counts, yet there remains a stagnant number of behavioral health professionals. With even more demand in the near-future, and a behavioral health sector that is already drowning, change must occur. Preliminary efforts to curtail these gaps in behavioral health treatment have been made by organizations like Medicare, which has expanded payment codes to incentivize providers to take on more patients. However, many of these plans have been rendered obsolete due to the uncovered physical cost of expanding a practice. Adding insult to injury, even the headways made in telehealth are at risk of being retracted, with more and more providers failing to seek renewals on digital health contracts as the pandemic subsides and the emphasis on in-person services returns.
From a macro level, the situation is just as urgent, with investment in the behavioral health sector continuously lagging behind demand, even falling 56% from 2021 to 2022. Looking to new tech to fill this gap, the lack of trained professionals will have to be the focus of innovative solutions to stop the bleeding in behavioral healthcare. Yet in a field as complex as behavioral health, one cannot be certain if this new outbreak will end anytime soon.