Although a lot has changed for us as a society over the last few months, the need for individual medical and mental health care hasn’t gone away. What has changed, in many cases, is how that care is provided. Because face-to-face appointments violate social distancing practices and risk the transmission of COVID-19, it’s become common to conduct patient encounters by telephone or video conference – an alternative also known as telehealth.
Telehealth is defined as the delivery of health and health-related services via telecommunication and digital communication to facilitate long-distance care. This includes medical care, patient education, health information services and self-care. Telehealth providers are reporting huge spikes in the use of their services in recent weeks. One aspect of telehealth that’s seen a particularly large increase in usage is telemental health or teletherapy. Teletherapy refers to mental health services and counseling provided via the Internet, phone, email or text message rather than in person.
COVID-19 Driving Increased Need for Teletherapy
Anxiety disorders are the most common mental illness in the U.S., affecting over 40 million adults, and the rates in Canada are similar. Just like physical illnesses, people with existing mental health illnesses need to continue with treatment. Unfortunately, as a result of the coronavirus, many people already struggling with an anxiety disorder or other mental illness are currently experiencing increased levels of stress and anxiety. Psychotherapy and psychiatric management, including management of mental health medication, must continue in order to prevent further decline and avoid potential consequences like suicide attempts, emergency department visits and psychiatric hospitalizations.
We are also seeing that people who have never experienced a mental health-related issue are struggling during these stressful times. The societal effects of the coronavirus, such as social isolation, fear of getting sick, uncertainty of when this will end and the economic fallout are causing an increase in stress and anxiety for almost all of us.
The Various Modes of Telehealth
Live video – two-way interaction between a person (patient, caregiver or provider) and a provider using audiovisual telecommunications technology.
Mobile health (mHealth) – refers to healthcare applications and programs patients use on their smartphones, tablets or laptops.
Remote patient monitoring (RPM) – uses digital technology to collect medical and other forms of health data from individuals in one location and electronically transmit that information securely to health care providers.
Store-and-forward – Allow for electronic transmission of medical information, such as digital images, documents and pre-recorded videos through secure email.
Regulation Changes Ease Teletherapy Barriers
In addition to increased demand, changes in regulations are making it easier for people to access mental health care online. The U.S. Department of Health and Human Services (HHS) recently relaxed standards that previously made it nearly impossible to meet digitally with a doctor because of privacy concerns under the Health Insurance Portability and Accountability Act (HIPAA). In addition, HHS has strongly encouraged plan sponsors to promote the use of telehealth and other remote-care services, including mental health and substance use disorder services. We encourage you to check with your individual LIUNA health & welfare fund or insurance provider to see whether your plan provides access to teletherapy.
Potential Challenges of Teletherapy
While it’s vital for people to have access to telehealth and teletherapy services, people should be aware that the format can also create new challenges. People staying home with family members (including young children who require supervision) or roommates (especially in a smaller living space) may lack the time or privacy to do a video or audio chat with a therapist without being overheard or interrupted.
As we begin to discuss how to “reopen” society and get back to “business as usual,” it seems clear it’s not going to happen overnight. The stress and strain that many people are feeling is likely to exist for a long time, especially depending on their experiences during the pandemic. It is important that people continue to take their mental and emotional health seriously and seek help when needed. The increased ease and access to mental health care, especially via teletherapy, will hopefully help more people seek assistance.
[Jamie Becker is the LHSFNA’s Director of Health Promotion]