One out of every five Americans experiences some form of mental illness – a number that continues to grow each year despite an increase in awareness and treatment options. At 20 percent of the population, that means that about 44 million people deal with conditions like anxiety, depression or more serious disorders like psychosis. Sixteen million Americans suffer from major depression alone, which is the number one cause of disability around the world. Among the homeless population, 26 percent live with a serious mental illness. Nationwide, just over 10 million adults suffer from co-occurring disorders of mental health and addiction. These statistics come from the National Alliance on Mental Illness (NAMI).
Mental health continues to play an integral role in today’s health care system as a whole. Prison inmates, the homeless and even children suffer from a wide range of issues. Unfortunately, more than half of those who are dealing with a mental illness don’t get the help that they need. And problems start early. According to the NAMI, half of all chronic mental illnesses are evident by the time a person turns 14 while 75 percent of chronic conditions are present by age 24.
As America continues to reform its health care industry, more emphasis will be placed on mental health care. Telemedicine is one solution to the growing problem of how to treat people with mental health problems, especially those who live in underserved areas. Telepsychiatry is not a new concept by any means. In fact, telemedicine started in psychology, at the Nebraska Psychiatric Institute in 1959. Since then, psychiatrists and other mental health professionals have adopted various ways of utilizing technology in treating mental illness. Whether it’s a consultation with a psychologist via video conferencing at home or remote observation in an emergency room, Telepsychiatry has the potential to save lives. For those who live with mental illness, telemedicine offers several significant benefits.
For many people, seeing a professional for mental health problems is low on the priority list, even for conditions that require medication and ongoing counseling. For others, seeing a psychiatrist isn’t an option at all. People living in underserved areas – like rural communities, schools or prisons – often lack access to appropriate mental health care providers. Without access, a lot of mental illnesses go undiagnosed or unresolved, leaving millions of people to deal with devastating problems on their own. According to the Centers for Disease Control and Prevention (CDC):
- In 2013, just over 41,000 people committed suicide in the United States, which is about the same number of people who died from breast cancer.
- The number of deaths from suicide is three times higher than the number of homicides and six times higher than the number of deaths from HIV.
- Suicide rates have not decreased over the last 20 years, and white men over the age of 60 are twice as likely to commit suicide as the entire population in general.
- For people aged 15 to 34, suicide is the second-highest cause of death.
A person living with mental illness will typically see a shorter lifespan, ranging widely from 1.4 to 32 years. Mental illness doesn’t just affect the mind. People with mental health problems are also more likely to suffer from other physical conditions, like heart disease and pulmonary issues. If people got the help that they needed, the U.S. might see 350,000 fewer deaths per year.
Access remains one of the biggest challenges to getting people connected with doctors and counselors who can help. Telepsychiatry, which is most commonly used in hospital ER settings, allows patients to consult with real doctors without having to leave home or a local hospital. It’s also more affordable, making it more of a viable option for those with limited resources. In prisons, where psychologists are scarce and access to mental health services is limited, inmates would especially benefit from remote access to psychiatric support. Many inmates suffer from diagnosed mental conditions, and mental health could help to reduce recidivism. In other words, some instances of criminal behavior might be mitigated or prevented altogether with greater access to mental health services.
Continuation of Care
If you’re receiving treatment for a medical condition, including a mental health one, then continuation of care is critical to making sure that you’re responding well to the plan set out by your doctor. Unexpected emergencies, overbooking and even physician vacations can get in the way of regular appointments. Telepsychiatry allows patients to continue getting the care that they need even when their doctors aren’t available. This can make a big difference for someone with a severe mental illness, such as debilitating anxiety or bipolar disorder. Whether you book a session with a different doctor in the same practice, consult with your own doctor while she’s at a conference or check in to the local emergency room to continue your care, telemedicine enables you to stay on track with medication and counseling. Some insurance and health care providers even offer diagnostic and counseling services via phone or web application so that patients always have access to care when they need it.
Costs: Financial and Social
Mental health care costs continue to climb. In addition to the cost of diagnosing and treating mental illness, there are peripheral costs as well. Time off from work to see therapists, lost wages as a result of debilitating symptoms and the cost of Social Security disability payments are all added expenses when dealing with mental illness. At the request of the World Economic Forum, economists were asked to estimate the economic impact of mental disorders. By 2030, researchers estimate that the costs associated with mental illness will reach $6 trillion. In 2012, mental disorders cost the United States about $467 billion when accounting for peripheral expenses.
Telemedicine reduces the financial burden of mental health care by ensuring that there are more resources – and more psychiatrists – available to serve the people who need help. In 2009, a pilot program in South Carolina proved that Telepsychiatry could help mitigate the cost of mental health care. Due to a shortage of hospital beds for psychiatric patients, mental health care in South Carolina declined steadily for decades before a new state health director implemented a technological solution. Since the program was launched six years ago:
- More than 21,900 patients have been seen remotely.
- There have been about 400 virtual consultations each month.
- People who utilize the telehealth services experience shorter hospital stays, resulting in about $1,400 savings per incident.
The National Institutes of Health compiled research on Telepsychiatry to look at its impact on mental health care. In terms of cost, the results were mixed. On one hand, some rural areas have seen substantial reductions in costs thanks to the implementation of Telepsychiatry. One study found that Telepsychiatry reduced the cost of mental health care by as much as 70 percent in a particular rural area. On the other hand, a separate study found that Telepsychiatry cost more per hour than regular, face-to-face consults.
Despite these mixed results, it seems evident that telemedicine can greatly improve access to and quality of care for people who need help. Along with the financial benefit, there are obvious social advantages to getting help via Telepsychiatry. Some people with mental illnesses prefer the comfort of their homes to a physician’s office or hospital.
In a prison setting, access to patients who need mental health counseling is easier and safer from the psychiatrist’s point of view. In smaller communities, where people tend to know each other on a more personal basis than they do in larger cities, remote access to psychiatric sessions could provide better protection and privacy. Hosting a video conference in your home, for instance, is much less likely to draw attention than making a special trip to the local counselor’s office. As telemedicine becomes a more integral part of the health care delivery system, greater advances in Telepsychiatry could promote better opportunities for mental health care for a diverse range of patients.