National attitudes have greatly shifted over the last 25 years towards the idea that mental and emotional well-being are vital to a person’s overall health. Today, nearly six in ten Americans have sought or want to seek mental health care for themselves or someone they love. While stigma and costs persist as primary barriers to progress for solving the mental health crisis, the key issue—as we have increasingly come to understand in the healthcare field—is lack of access.
In a 2014 study, researchers found that patients had an estimated wait time of 25 days before seeing a psychiatrist—and this study only observed urban areas, where care providers of all kinds are typically more abundant. Meanwhile, 80 percent of rural counties in the United States don’t have a single psychiatrist. Since 1995, there has only been a 12 percent increase in psychiatrists, and only 4 percent of current medical residents go into psychiatry—these rates are far outpaced by population growth nationwide.
With millennials and generation Z seeking more mental health services than previous generations, the problem of access is not going away anytime soon, and it may worsen without proper incentives or strategies in place. In the meantime, it’s important to understand how practitioners can leverage existing technologies to address and overcome this gap in patient access to licensed behavioral health specialists.
In many cases where the availability of behavioral health specialists is sparse, the onus falls on the primary care provider to offer stopgap solutions. Fortunately, digital tools exist that primary clinicians can use to bridge this divide and make the handoff to behavioral health specialists smoother. Mobile apps are becoming increasingly sophisticated in their ability to tackle the issue of access and provide tools and assessments that empower both clinicians and patients.
In speaking with a colleague, she shared the recent experience of treating a patient with medication for ADHD, but their symptoms are worsening. Her patient also reports poor sleep and worsening appetite. She referred the patient to a local psychiatrist to evaluate a comorbid behavioral health issue, only to discover their next available appointment is two months from now. But what if the physician was then informed of a possible new diagnosis through tools helping her patient to proactively manage symptoms and track their mood by answering standardized clinical questionnaires. She may then pivot to refer the patient to a social worker or other behavioral health specialist in the meantime. Additionally, the physician can share these standardized assessment results with the psychiatrist before the visit, giving them information that is clinically useful in prescribing and managing multiple psychiatric medications.
As digital tools and upstart companies continue to emerge and fill the gaps across the continuum of care, health care practitioners will need to assess, integrate, and commit to such tools in the name of finding creative solutions to the intractable problem of access. Failure to do so means that patients, especially those with elevated risks, will continue to get lost in the shuffle as they try to navigate an increasingly complex healthcare system. Moreover, digital solutions allow more optimized care coordination, whereby primary care providers and other non-behavioral specialists can reduce the burden on behavioral health specialists by managing lower-risk patients. The specialists can then concentrate their practice on more severe cases and establish capacity for timely intervention for emergency cases.
Not only will technology help address issues arising from inadequate access of patients to behavioral health specialists, but it will also strengthen communication between specialists and primary care providers for better care coordination. In the constantly changing environment that is health care, we must seek to implement solutions that increase the capacity of every link in the chain of care delivery. After all, the problem of access in behavioral health is not going anywhere.
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