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Virtual Behavioral Health Care Innovations Improving Health Equity

6 min read

To keep a competitive edge, employers are seeking to build better benefits, including increased telehealth services and access to more behavioral healthcare. As many as 84% of large U.S. employers report that adding benefits to attract and retain high-quality employees is important or very important to their organizations. Many health plans and employers are turning to vendors known as point solutions, usually virtual or hybrid programs targeting specific conditions from specialized third-party partners.

These telehealth specialty solutions can be a high-value way to extend and enhance care available to employees and their families and close gaps in care that are barriers to health equity. With true health equity, all people regardless of who they are, where they live or what they look like can access the high-quality care they need to reach their full health potential. 

Telehealth can be especially meaningful here in Arkansas, a largely poor, rural state with a high percentage of citizens with chronic health conditions and limited access to healthcare. Point solutions offer an affordable way for Arkansas employers to enhance their benefits packages, improve employees’ health and lower long-term health costs. These point solutions, whether they address women’s health and maternity, diabetes care, musculoskeletal care or dozens of other areas, increase access to high-quality virtual care that complements rather than replaces the services at traditional healthcare facilities. 

Why behavioral health is more than a nice-to-have benefit

One important area where there is a dearth of in-person providers to meet the high demand is in behavioral health, comprising treatment of mental illness, neurodiversity diagnoses and substance use disorders. Martye Nelson, manager of behavioral health clinical services at Arkansas Blue Cross and Blue Shield, said virtual behavioral health partners are a welcome presence, particularly in areas of the state where behavioral healthcare providers can be hard to find or schedule timely appointments.

“Behavioral health and physical health go hand in hand. There is no medical health versus mental health—it is all just whole-person health,” Nelson said. “So, it’s exciting to have new resources available to address the real challenges people face across the spectrum of behavioral health conditions. And these behavioral telehealth resources make getting help accessible, affordable, convenient and discreet. They break down barriers and improve patients’ health equity. Whether they live two hours from a psychiatrist or need the expedience of virtual visits, they’re able to have equal access to that care.” 

A National Institutes of Health study of behavioral health found that virtual programs had higher completion rates, attendance rates and number of treatment visits. The authors concluded that “virtual behavioral health had equivalent outcomes to in-person treatment, and that attitudes toward telehealth changed over time.” Simply put, they work, and people are becoming more comfortable with telehealth care. 

Bringing recovery support online

While virtual counseling appointments are becoming common, one relatively new application of telehealth is to treat substance use disorders (SUD). Nelson said while some people need inpatient or in-person treatment and recovery programs, others benefit from the personalized support and accountability possible through telehealth SUD programs from experts in the field.

Using telehealth for SUD treatment is fairly new in Arkansas,” Nelson said. “California has been doing it for a while, and they’ve seen some compelling successes with it.” 

She explained that the specialists in SUD telehealth manage patients’ medication-assisted treatment, often coordinating with a cross-disciplinary team to provide personalized therapy and peer support from others who have had success with recovery. “The programs are virtual, but they work in conjunction with the patient’s other providers, such as their primary care provider or psychiatrist, so they have a full picture of their health, then keep everyone updated on the patient’s progress and medication adjustments.”

Nelson said that overall, primary care providers and traditional behavioral health providers are often overextended and seem to appreciate the extended resources. “A lot of primary care providers aren’t staffed to provide medication-assisted treatment for substance use disorders, and due to busy practices, do not have time to get extra training or staff in place to offer that type of service,” she said. “But virtual substance use treatment services can extend a primary care provider’s reach so their patients who need it can get that expert care expediently wherever they are.”

“For members who can’t get an appointment with a SUD specialist or who live far from a recovery program, have transportation challenges or who are self-conscious about presenting in person at a treatment center because of the stigma still associated with many behavioral health issues, it gives them access to effective, discreet treatment in the privacy and convenience of their homes. And at the same time, it’s supporting those local providers who haven’t had an accessible treatment center or SUD provider to refer patients who struggle with unhealthy relationships to addictive substances.”

Caring for the next generation

Another exciting area of behavioral telehealth specializes in pediatric care. 

“Kids today are often more comfortable interacting online than their parents are,” Nelson said. “Even in kindergarten they have iPads now, so kids are very familiar with digital technology. And for a lot of teens and young adults, telehealth is actually their preferred way of accessing healthcare.”

Depending on the vendor, pediatric telehealth can cover the full gamut of behavioral health issues kids experience, from professional care for neurodiverse needs such as autism, learning or attention disorders to mental health diagnoses of all sorts. The visits typically involve diagnosis, medication management, counseling and therapy sessions enabled by videoconferencing.

“When working with children, the virtual behavioral health providers are really working with the whole family,” Nelson explained. “They’re involving the parents or guardians but also the child’s siblings or other close relatives,” Nelson said. “The best behavioral health plans include supporting the family, because kids don’t go through these things alone; the whole family is affected, and the family benefits from the cohesive support and learning how to meet the child’s needs effectively.” 

The treatment from child psychiatrists may include managing medications as appropriate, while looping in the patient’s pediatrician. Individual, family and group therapy from child psychologists and licensed counselors and testing by psychological examiners may be other components of behavioral telehealth for children and teenagers. Videoconferencing may be supplemented by an app that offers educational resources, engagement strategies, a connected community or behavioral prompts to support healthy choices between telehealth sessions. 

Sometimes behavioral health needs are urgent in ways traditional treatment facilities can’t always accommodate. For instance, Nelson said that in cases where the child or teen is experiencing suicidal ideation from depression or anxiety, or coping with bullying or other trauma, having expert behavioral healthcare available through their phone can be a lifeline for the child and for the family. “When the stakes are high, it’s vital to get the child professional care as soon as possible,” Nelson said, adding that’s an area where virtual programs excel, because there is not a significant wait for an appointment. With this benefit on their health plan, families can be talking with an intake coordinator almost immediately.

Full-body care for the whole person

Nelson reiterated that whether seeking behavioral health services online or off, it’s vital that the providers take a holistic, collaborative, patient-centric approach that considers the full picture of their medical and behavioral needs, as they’re “integrally connected.”

She said when patients see improvement in their behavioral health issues, whether its managing mild or severe mental illness, developing strategies to help children on the autism spectrum or recovering from substance use disorders, their progress in behavioral health benefits their whole health and well-being. “Besides successful outcomes feeling good for everyone involved,” Nelson said, “their improved behavioral health reduces future medical expenses and boosts their productivity at work and home. It’s such a good investment.”

For more information about behavioral health resources in your community, visit mymindhelp.com and samhsa.gov

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