Broadband technology is being heralded as a way to broaden access to behavioral health services, especially in rural and underserved areas of the country where shortages of mental health professionals exist.
The difficulty of providing access to such services is typically not widely discussed, but it’s a growing area of concern to behavioral health professionals. They cite the fact that although one in five American adults has a mental illness, only about 40 percent of those affected have access to behavioral health services.
However, while broadband technology holds promise in ameliorating the situation, a variety of legal, regulatory and technology issues stand in the way of improving access to care.
“Broadband connectivity, through telepsychiatry and other connected health platforms, can be transformative when it comes to mental healthcare,” said Mignon Clyburn, commissioner of the Federal Communications Commission at a policy conference on May 18 at the University of Houston Law Center.
Clyburn noted that mental health illness last year impacted more than 42 million Americans. “Millions are not receiving care. By one estimate, 60 percent of U.S. adults with a mental illness do not get the type of care that they need.”
Nonetheless, according to Clyburn, telepsychiatry has been shown to improve access to behavioral health services, increase patient satisfaction, and produce real savings when it comes to time, cost, and travel. “In the case of telepsychiatry, we’re taking physical interaction and virtualizing it,” she said. “Connectivity is being used as a pillbox to deliver much-needed medicine.”
What’s required to drive the widespread adoption of telemedicine technologies to transform mental healthcare is “regulatory creativity and flexibility—yes, I said it out loud,” Clyburn exclaimed. “We must not accept the status quo that connectivity gaps and health disparities go hand in hand.”
“Getting broadband more pervasive in disadvantaged areas is critical to ensure that we all can have access to healthcare,” added Bernard Harris, MD, former president of the American Telemedicine Association and CEO and managing partner of Vesalius Ventures, a venture capital firm that invests in telehealth companies.
Robert Robbins, MD, president and CEO of Texas Medical Center, told the audience that Houston is the most diverse city in America and is home to the world’s largest medical complex. “Yet, in the shadows of this incredible, high-tech facility, we have a population in this city that really doesn’t have adequate access to medical care and mental health is a major problem,” Robbins said. “Our largest healthcare facility is the county jail.”
Leonard Baynes, dean of the University of Houston Law Center, pointed out that Texas has racially diverse residents, large numbers of veterans and isolated rural areas, and because of those factors, the Lone Star State is particular vulnerable to the problems of access to behavioral health services and could benefit from telemedicine.
Baynes noted that the Health Resources and Services Administration has estimated that more than 80 million Americans live in areas with a shortage of mental health professionals, which includes 362 mental health shortage areas in Texas, as determined by HRSA.
When it comes to the veteran population, he said that research continues to show that military service members deployed in Afghanistan and Iraq may experience a variety of mental health issues when they return to their communities.
“About 22 veterans per day, or nearly one per hour, lose their lives to suicide because of untreated mental illness,” Baynes said. “However, innovators in mental health treatment are utilizing telehealth counseling and telepsychiatry to reach veterans suffering from mental illness in some of the most remote areas of the state.”
Toward that end, the Department of Veterans Affairs on May 16 announced the establishment of five VA Mental Health Telehealth Clinical Resource Centers to provide enhanced mental health access and services to veterans in remote locations.
“These mental health telehealth resource centers will provide our veterans in underserved areas the expert mental health providers they may not otherwise be able to obtain locally,” said David Shulkin, VA’s under secretary for health. “We know that we are doing more in telehealth than any other healthcare system, and connecting mental health providers to areas hard to recruit and retain.”
Slated to open this summer, the VA centers will be located in Charleston, S.C., Pittsburgh, Salt Lake City, and a consortium of facilities in Boise, Idaho, Portland, Ore., and Seattle. The fifth center, already operational in West Haven, Conn., is a specialty hub focused on the most severe and complex mental health issues, such as chronic depression and bipolar disorder.
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