A new study suggests that more than half of people receiving mental health care will want to continue receiving care almost after the pandemic.
One year ago, only 26 video visits by University of Michigan mental health providers had occurred in nearly six months, compared to more than 30,000 personal visits.
But Jennifer Severe, one of the three psychologists who helped launch a telehealth campaign test in the outpatient psychiatric clinic, was not about to give up.
She prepared to deliver a speech at the beginning of April 2020, hoping to convince more of her colleagues to try telepsychiatry, now that a major insurance company was paying for it. She even had examples of how clinic staff had “rescued” patient care who asked at the last minute to cancel a prescription for depression or bipolar disorder but agreed to video therapy session instead.
Severe never got to give that speech.
Instead, on March 23, all non-emergency health care across the state closed to prevent the spread of COVID-19. And video chat and phone calls were the only way most patients could connect with their psychologists and psychologists from Michigan Medicine, the university’s academic medical center.
For almost all of these patients, it has remained that way for the past nine months.
According to the new findings published in JMIR Creative Research, the convenience of seeing a provider without leaving home, and avoiding potential exposure to the coronavirus – especially for those with other underlying health concerns – contributes significantly to this choice. . Thus a patient’s initial experience with seeing a provider is almost negligible.
Phone or video?
The data come from a summer 2020 telephone survey of 244 patients or parents of patients who had arranged appointments with a University of Michigan mental health provider in the first weeks of the pandemic-related closure. Nearly 83% decided that the first meeting at a broadcast time via video chat would be in their place.
But the study also suggests that the minority of patients who first chose to continue with psychiatric care through phone calls needs special attention.
Although this made up less than 14% of the study population, they were more likely to be over 45. By the summer, they were much more likely to seek remote mental health care future.
As health insurers and government agencies make decisions about whether and how to pay mental health providers for meaningful care in the short and long term, the new data could help giving them information, says Severe.
“We went from not being overly attracted to telepsychiatry, and met with a great deal of trust among providers and patients, to getting almost all of our care, and offering help to those who it is needed, ”she says. “These data suggest that the opportunity to turn a pandemic experience into an opportunity to improve access to mental health care and improve continuity of care. But policy and reimbursement decisions will be important. ”
Almost all patients in the study group who were on a meaningful visit in the summer said it went as well as they expected, or better.
Parents of children receiving mental health care or health behaviors from psychiatric department providers in particular noted that video tours were more interesting.
Phone visiting patients said it was important to have the option of talking when their internet connection was unstable or when they had a problem with the video platform. A third said they were just more comfortable talking on the phone.
Meaningful mental health care
Although the new paper does not examine the elimination of clinical function and unexplained rates, documentary evidence indicates that it has declined significantly from a one-to-four level prior to the pandemic.
Whether it is a devastating effect on their mental health condition, or their access to transportation, time off work, or childcare, many factors can affect a patient’s pursuit of a personal career, Severe says. But meaningful tours remove most of those barriers.
Cost is another potential barrier to telephone-based care. In the trial months prior to COVID-19, insurers would not normally cover phone calls, leaving the provider to cover the cost or ask patients to pay out. the pocket to talk on the phone with their provider.
Insurers covered phone-based mental health care for much of 2020, but that seems to be coming to an end soon. But Severe says that for some patients with a relationship established with their mental health provider, phone and video jobs are just as effective and they should get an equal refund from insurers. .
“For the first visit with a new patient, we try to avoid telephone calls as it limits the onset of the provider-patient therapeutic alliance, reduces communication issues, and limits the mental status test that is available. including observing patient facial expressions, interactions and movement. , ”She says. “Given the complexity of the patient’s condition, we may need to have a physical examination from time to time, to assess their balance and mobility, and to check for medication side effects to name a few. . ”
Going forward, Severe hopes to explore more aspects of telepsychiatry in the era of COVID-19, including an understanding of socioeconomic status, rural vs. urban living, access to technology , and other items playing into your reach. She notes that the inspection team chose to conduct their survey over the phone, rather than reaching out to an email or patient portal message, to ensure maximum accessibility.
Source: University of Michigan