[Guest post by Lissette M. Saavedra and Anna C. Yaros]
Across the United States, it long has been a struggle for mental health service provision to meet the needs of individuals with mental illness. The COVID-19 pandemic has hit everyone especially hard, including parents, youth, front-line workers and first responders. Everyone has had to adapt quickly to living in quarantine, having less access to outside activities, and taking on roles they never expected to, or were not trained to do. While many individuals continue to adapt to the ongoing changes, too many struggle with ways to cope. In response, health care organizations have relaxed regulations to allow more flexibility and access to services via telehealth. Many behavioral health providers have been quick to embrace telehealth solutions to continue caring for their patients and clients, while keeping their workforce safe at home. Although video and other technology-based solutions have a growing body of evidence in many healthcare disciplines, the evidence for mental health services is limited. Still, these extreme circumstances have accelerated the adoption of telehealth in most disciplines, even among those new to this technology. Providers and patients with limited experience or inclination to work in these spaces have found themselves quickly learning to navigate this new world.
These challenges are part of the reason why it is so important to put a spotlight on advances in telehealth: to give people hope but also to ensure that researchers and providers work together to develop this capacity in the right ways. Because of that need, we were pleased to have a chance to talk about these issues on an episode of The Measure of Everyday Life. Writing about these concerns in peer-reviewed journals is useful and important, but it also is important for us to discuss such concerns in many different venues, including public radio. Reaching people outside of universities and research institutes is going to be very important for us to move ahead.
In this spirit, we want to emphasize that telehealth attends to challenges with treatment engagement and access to care particularly well in these times but challenges also remain to be addressed. Standards for privacy that were prevalent pre- COVID-19 might be very different in the pandemic. Quarantine contexts bring up new worries related to privacy and safe spaces to be able to speak freely and privately. Patients who are not familiar with telehealth may need support to help find the best places to connect with their provider. Relatedly, the COVID-19 pandemic revealed a harsh reality that was always there but amplified while in quarantine and in later phases of the pandemic: individuals from vulnerable populations are exponentially more vulnerable now. Even with telehealth, not all patients have equal access to connectivity and private spaces to receive care. This has been seen with patients and clients from both urban and rural settings, but rural settings often are particularly affected.
Whatever mental health and addiction service provision looks like in our near future will call for careful consideration of our most vulnerable populations. Issues and recommendations raised in this commentary were needed before the COVID-19 pandemic in rural telehealth mental health and addiction service provision but are now ubiquitous concerns across the United States. When navigating in these unprecedented and uncertain times, these considerations will be important for understanding how to help most practitioners who were not formally trained in telehealth service provisions. Researchers, practitioners, policymakers, and various media outlets can come together and help shed light on how the mental health of our country evolves and what issues need careful attention. Collaborations in science and help from the media in the amplification of our findings and messages is achievable but also critical to help the patients we serve.
Lissette M. Saavedra and Anna C. Yaros are researchers at RTI International.
The Measure of Everyday Life 