Mental Health is in Crisis. We Need Telehealth to Tackle It.
In the early months of the COVID-19 pandemic, the federal Department of Health and Human Services acted quickly to ease restrictions temporarily on telehealth. This move enabled doctors to use a variety of technologies to connect with patients remotely, to see patients across state lines, and to bill the same amount for remote visits as they normally would have for in-person visits.
These changes were vital. They allowed doctors to continue to treat their patients, and patients to continue to get the high-quality care they needed. We were in the middle of a national crisis: the old rules governing the use of telehealth no longer made sense. We needed new rules.
At Skyler Health, we believe it’d be a mistake to simply reinstate those old rules when the COVID-19 pandemic is finally behind us. As former Chief Medical Officer at HHS and Dr. Vanila Singh puts it, COVID-19 is not the only crisis we face. The opioid crisis and the mental health crisis also require our urgent attention — and we’re going to need telehealth as a tool in our toolbox to address both of these crises.
The extent of the opioid crisis is well publicized. Before the pandemic began, this crisis and what drug companies knew about the addictive nature of these powerful drugs regularly made headlines. Even as the pandemic marches on, major drug companies are moving towards a massive $26 billion settlement over their role in seeding the opioid epidemic.
2020 was dominated by headlines about COVID-19 as a disease attacking the body. As the COVID-19 pandemic abates, we will begin to see the shape of the massive mental health crisis it will leave behind. Even before the pandemic began, about 1 in 5 American adults dealt with an anxiety disorder in a given year, and 1 in 3 suffer from an anxiety disorder over the course of their lifetimes. One in four Americans experiences acute insomnia in a given year. While major depression is relatively less common, affecting about 7% of U.S. adults in a typical year, that still represents more than 17 million people who are struggling.
The COVID-19 pandemic has intensified this simmering crisis. Studies have shown that as many as 40% of all Americans have experienced at least one mental health issue during the pandemic, including anxiety, depression, trauma, or substance use. One in four young adults ages 18–24 have experienced suicidal thoughts. The number of people struggling with anxiety has tripled; the number of people dealing with depression has quadrupled; the number of people contemplating suicide has doubled.
Dr. Singh believes that we should treat these statistics as a full-blown crisis. The regulations that were temporarily loosened to allow providers to deal with the pandemic should not be tightened again at a moment when we will need all hands on deck to deal with this explosion of serious mental health issues. Regulators should acknowledge the opioid epidemic and the mental health crisis as severe, emergency situations, and treat them accordingly.
That means that doctors should continue to be allowed to use telehealth as a viable option, including treating patients across state lines if necessary. The use of telehealth means that patients who live in rural areas or otherwise live far away from specialists who could help them can get the treatment they need. Allowing more flexibility with telehealth will help more patients get access to care at a time when millions of people are in urgent need.
Expanding telehealth also allows patients to access the best possible care for their particular issues. Take this example: Say your teenage child is dealing with PTSD and is at high risk of suicide. Now imagine there’s a doctor in another state who specializes in treating teens with PTSD who are experiencing suicidal ideation. “You want that person to address that issue,” Dr. Singh says. Broader use of telehealth allows providers who specialize in a particular type of patient to more easily see the patients they’re best qualified to help, regardless of location.
At Skyler Health we specialize in offering medication tapering support for those struggling with opioid or benzos usage. That kind of specialized care is still emergent in this country and requires telehealth to connect patients with the care they often desperately need.
The Telehealth Caucus in the House has already introduced a bipartisan bill, called the Protecting Access to Post-Covid-19 Telehealth Act, which would permanently remove geographic restrictions on telehealth care, and would also give HHS ongoing authority to declare a health emergency and waive restrictions as needed. Action like this is urgently needed to address the growing mental health crisis in this country.
Doctors and patients need as many tools as possible to deal with the growing wave of trauma, anxiety, depression, and substance use. Telehealth is a crucial tool that, even after the COVID-19 pandemic passes, will help more patients get the care they need.
