In the wake of the Covid-19 pandemic, the need for behavioral health services has never been greater. According to the World Health Organization, during the early days of the pandemic, the global prevalence of anxiety and depression increased by a massive 25%.
In the U.S., Mental Health America’s 2022 State of Mental Health in America Report has some staggering numbers:
- Over half of adults with a mental illness do not receive treatment, totaling over 27 million adults in the U.S. Although adults who did not have insurance coverage were significantly less likely to receive treatment than those who did, 54% of people covered by health insurance still did not receive mental health treatment. This statistic indicates that ensuring coverage is not the same as ensuring access to mental health.
- 15.08% of youth experienced a major depressive episode in the past year.
- 24.7% of adults with mental illness report an unmet need for treatment. This number has not declined since 2011. One contributing factor is a shortage of psychiatrists and an overall undersized mental health workforce.
The rise of digital mental health
If the pandemic did one thing, it forced us to rethink how we handled many aspects of life. It wasn’t just work, school, and happy hour that went online. It was healthcare as well. The number of mental health facilities offering telemedicine services shot up from 38% nationally in 2019 to just over 68% in 2020, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
However, before the pandemic, telemedicine for mental health services had already started to see a rise in popularity due to an increase in reported mental health struggles. In 2020, SAMHSA reports, 11% of U.S. adults — 26.3 million people — received virtual services for a mental health issue.
And with apps like BetterHelp, Talkspace, and Calm, a therapist can be just a click away, according to the European Connected Health Alliance. With more than 380,000 health apps available through Apple and Android operating systems, including around 20,000 that address mental health, there is no shortage of apps that can help.
How it works
Telemedicine has no doubt made mental healthcare more accessible. It has removed the physical and geographic barriers to access and offers scheduling flexibility for both patient and therapist.
Individual, one-on-one therapy is one of the most common forms of mental health treatment. According to the U.S. Department of Health and Human Services, there are a number of ways to deliver it.
Virtual talk therapy: Telehealth talk therapy visits address emotional and psychological issues, typically for 50 minutes per appointment. Providers typically conduct online counseling with a patient through video, phone calls, or online apps.
Telepsychiatry: Telepsychiatry can offer a range of services, including online counseling and psychiatric evaluation and diagnosis. Unlike talk therapy, the provider may also prescribe medications and address medication management.
Online apps: Apps can be useful for tracking and monitoring mood, though they may require users to first enter information about their symptoms. App offerings vary and may include built-in features like text therapy, talk therapy, or chatbots. They may also offer resources, quizzes, access to online communities, guided meditations, or suggestions for activities. Apps can help users better understand moods and emotions and reframe negative thoughts.
Chatbots: Mental health chatbots use software programmed to mimic human conversation. They provide real-time encouragement, advice, and tips for emotionally challenging situations. Chatbots offer 24/7 support, which is helpful during weekends or evenings when more traditional forms of therapy are not always available. Typically a patient or the chatbot itself initiates the conversation.
Text therapy: Text therapy offers the convenience and relative anonymity of text messaging. Unlike chatbots, text therapy offers the assurance and support of a real person at the other end. Some text therapy lines offer 24/7 support in real-time. Others provide responses from licensed professionals asynchronously or during different times of the day. There may be some wait time to get advice.
It’s here to stay
And even as the pandemic wanes, data show that digital mental health is sticking around. Although it was already a booming business in 2020, when the digital mental health market was around $142 billion in sales, within five years it is projected to reach $427 billion, according to Global Market Insights.
Its usage is also growing. Born out of necessity during the pandemic and lockdowns, virtual care models expanded rapidly, bringing about new expectations for effective and reliable healthcare at a distance. Although prior to the pandemic, consumers had not been widely using these services, they are overwhelmingly willing to do so today. According to a 2020 report from Accenture, 81% of consumers diagnosed with or experiencing a behavioral health condition definitely or probably would engage on a virtual channel.
In addition, a 2021 survey from the American Psychiatric Association of more than 1,000 U.S. adults over the age of 18 found that 38% of participants used telehealth services to talk to a medical or mental health professional. 82% said they started using those services during the pandemic. In addition, more than four in 10 respondents said they continued using those services once most of the lockdowns associated with the pandemic were over.
Pros and Cons
Is digital mental healthcare effective? It depends on who you ask. Several studies have already supported telepsychology’s effectiveness. And research from Jeanine Turner, Ph.D., a professor of communication, culture, and technology at Georgetown University who has followed telehealth’s growth over the past two decades, has shown that both patients and providers who use telehealth generally view it favorably.
But despite telehealth’s convenience and ability to eliminate stigma, not every study is as encouraging. For example, a 2019 study of apps for suicide prevention found that suicide helpline phone numbers were often inaccurately listed or weren’t listed at all. At the time of the study, those apps had been downloaded more than 2 million times.
A September 2021 report called Frontiers in Digital Health concluded that there is only limited evidence that digital mental health tools can be successfully implemented in clinical settings. The study’s authors pointed to a lack of technical and medical standards for digital mental health apps, personalized neurotechnology, and assistive cognitive technology as a possible cause of suboptimal adoption and implementation in the clinical setting. Further, ethical concerns have been raised related to insufficient effectiveness, lack of adequate clinical validation, user-centered design, and data privacy vulnerabilities of current digital mental health products.
The report also noted growing evidence suggesting that digital mental healthcare can improve conditions such as depression across various patient populations.
Although virtual and digital care isn’t for everyone, it can improve affordability and provide critical additional access in behavioral health emergencies and other high-need situations.
If you are in need of mental health care, Healing Breaths can help. Our mission is to help healthcare workers and leaders refresh, improve personal resilience, and rediscover the joy of medicine. Click here to speak with one of our healthcare wellness experts.