After COVID-19, Virtual Health Is a Mission-Critical Strategy
Kevin Davidson, Vice President, Business Development & Strategic Services, MemorialCare and Oliver Lignell, Vice President, Virtual Health, AVIA
Vic Siclovan, Director, and Hanna Helms, Manager, Medicaid Challenges, AVIA
The immediate impact of COVID-19 and the resulting long-term consequences are creating significant demand for historically scarce behavioral health services.
Living through a pandemic is stressful and anxiety-inducing. The stay-at-home measures put in place to contain the spread of COVID-19 are compounding this stress, resulting in social isolation and unprecedented economic hardship, including mass layoffs and loss of health coverage. These factors will likely worsen the conditions driving suicide and substance-related deaths, the “deaths of despair” that claimed 158,000 lives in 2017 and contributed to a three-year decline in US life expectancy among adults of all racial groups. The economists Angus Deaton and Anne Case, whose influential 2015 paper popularized the term, argue that business cycle fluctuations do not drive deaths of despair in the short term; however, they do believe that the coronavirus will likely worsen the long-term conditions that are responsible for these deaths.
Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 2018 data showed that only 43% of adults with mental health needs, 10% of individuals with SUD, and 7% of individuals with co-occuring conditions were able to receive services for all necessary conditions. In 2019, to improve behavioral health access and outcomes and address addiction, we launched the Behavioral Health Initiative and Substance Use Disorder Initiative with 30 health systems as part of the Medicaid Transformation Project. Together, these systems committed to building comprehensive behavioral health strategies with innovative digital tools and clinical best practices to help more people who struggle with untreated depression, anxiety disorders, post-traumatic stress disorder (PTSD), and substance use disorder (SUD).
This work is more important than ever. A concerted public and private effort is needed to redouble investment in behavioral health during and after the pandemic. Otherwise the all-consuming nature of the COVID-19 surge response will leave the US healthcare system even more poorly equipped to address the behavioral health crisis that has already exacted great human cost.
A pandemic tests everyone’s mental health and wellbeing. Different populations will be impacted in different ways, but there are meaningful and market-facing solutions that can help each segment.
Solution: Deploy digital solutions that expand access to low-acuity behavioral health services and connect socially isolated individuals to peers and online communities that can prevent exacerbation of behavioral health concerns.
Solution: Provide immediate (and free) access to behavioral health services to employees and their families, including therapists, psychiatrists, and online resources. UCSF is one example of how to do this well.
Solution: Connect individuals experiencing financial insecurity to financial assistance programs, social care services, and behavioral health resources.
Solution: Expand access to behavioral health services through digital modalities to support continuity of care in the midst of potential in-person service disruptions.
Solution: Implement robust screening practices and updated care protocols that take into account not only COVID-19 considerations but also the unique needs of complex, high-risk populations.
Solution: Provide temporary, isolated housing (e.g., renting out hotel rooms), testing at shelter sites, and easily accessible community behavioral health resources.
Solution: Form partnerships with local organizations well-versed in supporting individuals experiencing domestic violence, as healthcare organizations may not have these capabilities in-house.
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