New poll results from the American Psychological Association (APA) shows that adults in the US are experiencing the highest levels of stress since the pandemic began. This prolonged and elevated stress is fueling increased demand for mental health services. Without more trained professionals, better technology, and improved access, many who are suffering may not get the care or help they need.
More Stress Than Ever
According to the Stress in America: January 2021 Stress Snapshot survey conducted by The Harris Poll on behalf of the APA, the average reported stress level during the prior month was 5.6 (on a scale from 1 to 10 where 1 means “little to no stress” and 10 means “a great deal of stress”). This level was higher than what had been reported when the pandemic first started.
The January 2021 Stress Snapshot also showed that 84% of American adults reporting feeling “at least one emotion associated with prolonged stress in the prior two weeks”. The most common feelings were:
- Anxiety (47%)
- Sadness (44%)
- Anger (39%)
The Snapshot survey was conducted January 21-25, 2021 and included 2,076 US adults 18 years and older.
Mental Health Services Overwhelmed
A study released in 2016 by the National Center for Health Workforce Analysis (part of the Health Resources and Services Administration – or HRSA) concluded that by 2025 there would be a shortage of mental health professionals of more than 10,000 FTEs. These included: psychiatrists, school psychologists, behavioral disorder counselors, mental health counselors, and substance abuse social workers.
This prediction was made years prior to COVID-19 and the economic downturn it has caused. It should not be a surprise that experts are warning that mental health services are overwhelmed. The authors of a recent JAMA article, stated it plainly:
A second wave of devastation is imminent, attributable to mental health consequences of COVID-19. The magnitude of this second wave is likely to overwhelm the already frayed mental health system, leading to access problems, particularly for the most vulnerable persons. The solution will require increased funding for mental health.
Technology + New Approaches Can Help
To meet this increased demand for mental health services, providers are turning to new technologies and new delivery models. Healthcare IT Today reached out to one company that is doing some interesting work in this area – AbleTo – to find out more about their hybrid electronic Cognitive Behavior Therapy (CBT) and live therapist solution. We also took the opportunity to ask company representatives for their thoughts on the ROI of mental health services for employers and how access to these services could be increased – especially for those who are now out of work.
AbleTo is a hybrid solution that blends connection with a real therapist alongside electronic CBT therapy. Why has this approach worked?
Reena Pande, Chief Medical Officer at AbleTo: We have long believed that it is important to find the right blend of human and digital care to meet the needs of the patient. Mental health is not one condition requiring one solution; it encompasses a variety of complex conditions that require different interventions. For example, a patient with severe depression will need a higher level of care than someone living with mild stress or anxiety. And the modality by which that care is delivered may differ by patient with a digital approach not only offering convenience and accessibility, but also enhancing treatment with tools to practice the techniques they learn between sessions. The range in severity of conditions and other complicating factors like physical comorbidities make it necessary to offer a set of solutions that can address these nuances.
We have seen a significant increase in the demand for mental health services. In your opinion, how much of that increase was driven by the pandemic and how much would the demand have grown without COVID-19?
Trip Hofer, CEO at AbleTo: We’ve been seeing a steady rise in demand for mental health for years—in fact, demand has outpaced the current supply of therapists for some time now, making teletherapy so crucial for getting patients access to the care they need. The pandemic accelerated this trend. Isolation and loneliness have been a huge factor as people quarantine and practice social distancing. Stress and anxiety related to the pandemic have too, as people worry about their family’s health, their finances, and other stressors that have huge mental health implications.
Is there an ROI for employers and payers for mental health services?
Pande: The industry as a whole has become more aware of the undeniable impact that mental health has on many areas of patients’ lives. There’s no doubt that prioritizing mental health leads to cost savings, and addressing these issues in tandem drives lower medical spend.
Consider the fact that patients suffering from depression have a 40% higher risk of developing cardiovascular and metabolic diseases and that individuals with co-existing mental health and physical health conditions may experience up to four times greater total cost of care.
Mental health issues act as a major barrier to patient self-care in areas such as diabetes self-management, but when their conditions are addressed, patients adhere better to treatment plans.
We’ve seen in our own body of research that AbleTo participants have significantly fewer hospital stays when their mental health is addressed, reducing total medical spend.
Main street businesses have been devastated by the pandemic and a lot of people are out of work right now which means they don’t have coverage. Perversely this is the group that is most likely in need of mental health services. Is there anything that can be done to bridge this potential access gap?
Hofer: In the short term, considering the current health crisis and high unemployment, patients that need mental health support may be eligible to receive care through government-funded Federally Qualified Health Centers such as community centers. They may also be guided to mental health care sites by contacting the National Alliance on Mental Health’s (NAMI) helpline.
For an adequate long term solution, the wider industry, including payers in collaboration with regulators and policymakers, needs to expand access to high-quality mental health care through policy action. We need a societal response to this issue. What happens when someone loses coverage and they have a physical health need? Mental health care deserves the same robust response—a strong safety net that ensures people who temporarily lose coverage can still receive essential care services and meet these critical needs. As a provider of that care, we want to encourage a legislative and policy approach that fills those gaps in coverage.