Virtual psychiatric care offers opportunities – and potential risks
A sharp increase in the availability of telemedicine services has opened up new opportunities for mental and behavioral health counseling and challenges for healthcare providers, employers and employees.
Dealing with a “mental health crisis”
“The COVID-19 pandemic has unleashed an unprecedented mental health crisis” with rising cases of depression, substance abuse and suicide, said Dennis Urbaniak, executive vice president of digital therapeutics at global pharmaceutical company Orexo. “The ability to receive care regardless of a person’s geographic location or proximity is obviously attractive, particularly when it comes to mental health care, which unfortunately continues to be surrounded by stigma, especially in the workplace,” he said.
Small-town employees who may not have enough local demand for a particular type of group can still get the support and resources they need by connecting with others who could be located literally around the world, Urbaniak noted . So it’s not surprising that virtual mental health care options are on the rise.
At Voya Financial, Chief HR Officer Kevin Silva said telemedicine options for acute physical care for employees were available before the pandemic, but these options have expanded to include primary care and mental health care. “Telehealth visits have surged for Voya in 2020 and have yet to return to pre-pandemic levels,” Silva shared. “Many employees prefer the convenience of telemedicine [for physical and behavioral health visits] and it’s beneficial for employers because appointments happen faster and productivity is less impacted.”
Virtual care is also further automated by artificial intelligence, so sometimes the “doctor” an employee interacts with is not a doctor at all. Wysa, an AI and human-driven digital mental health app, offers advice and support from both recognized mental health advisors and an AI chatbot available 24/7 for employees and other users. The AI chatbot uses AI-CBT (cognitive behavioral therapy) to help people with their challenges and adapts to their unique situations based on their responses.
Zoom into group therapy
Many employees continue to feel isolated and anxious as remote and hybrid work continues. Being able to come together virtually to share concerns or participate in group treatment options can be helpful.
Zoom, the popular app for holding online business meetings, is now being used by some mental health providers as a virtual venue for behavioral group therapy or disease management support. For example, BrightView, a Cincinnati addiction treatment provider, is facilitating virtual group therapy via Zoom to “help create a safe environment [for patients] to heal emotionally, connect with others who understand your background, express your ideas, reflect on your experiences and engage in support,” the organization’s website reads.
psychology today, psychotherapist Sean Grover described how he began using Zoom for therapy groups he previously held in his New York office during the pandemic. “I didn’t have high hopes,” he wrote. “I chose not to charge for the first Zoom sessions because I was confident that online therapy groups would become a snooze feast. … I was wrong. From the first session I could see the group members [were] hungered for contact. They were thrilled to see each other.”
Zoom groups offer more flexibility for busy patients, Grover noted. Due to scheduling conflicts, illness, child care, and other priorities, group members have often had to “miss the session or even drop out of the group. Now they call from home, office or other places.”
As the pandemic subsides, Grover continues to offer Zoom sessions for individual and group therapy, as do other therapists, although some have raised concerns about the risks of hacking (see discussion of privacy issues below).
Early evidence suggests that virtual care is effective for mental and behavioral health problems. Virtual care provider Teladoc’s 2021 Mental Health Survey of 2,253 US adults found:
Seekers of psychiatric support give their virtual and face-to-face mental health care experiences nearly identically high ratings.
92 percent of virtual mental health seekers report at least some improvement during the pandemic, with over a third reporting a “breakthrough.”
75 percent of those with anxiety reported improvement after the fourth visit, and 76 percent of those with depression reported improvement after the third visit.
Despite this technology’s promise of serving a wide range of needs while improving access and even reducing costs, there are some caveats to be aware of. For example, the Teladoc survey showed that:
Almost 70 percent of respondents believe it is too difficult and overwhelming to use multiple websites, mobile apps and virtual care platforms to engage with their mental health.
78 percent said they prefer a single, unified experience for virtual mental and physical health care.
Using Zoom for group therapy could pose privacy risks, said Inga Shugalo, a healthcare industry analyst at itransition, a Denver-based software development company.
“It’s better to hold such meetings in a specific telemedicine tool, as healthcare technology providers usually take additional steps to ensure the end-to-end security of their customers’ health data in such apps,” she advised.
Concerns about privacy were also raised by Dr. Mark Kestner, chief innovation officer at MediGuru, a provider of telemedicine services.
“The data generated by the virtual visit must comply with data protection standards and be integrated into the clinical plan to measure the quality and outcome of care,” he said. “While the thought of ‘care everywhere’ is intriguing, there are limitations to clinical power, such as state licensing and eligibility for service.”
Employers must also exercise due diligence.
For both mental and physical telehealth care, “just like regular in-network providers, we need to continue to monitor the quality and cost of telehealth services and keep healthcare plans to the same standards they have for in-person visits and in-person providers ‘ Silva said.
Lin Grensing-Pophal, SHRM-SCP, is a Wisconsin-based business journalist with executive search experience.
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