An early April poll by the Kaiser Family Foundation shows that nearly half (45%) of all U.S. adults say the COVID-19 pandemic has affected their mental health, while 19% say it has had a “major impact.” Prescriptions for anti-anxiety drugs spiked 34% between February 16 and March 15, and also increased for antidepressants (18.6%) and anti-insomnia drugs (14.8%), according to a report from Express Scripts.
According to Hank Drummond, Chief Clinical Officer at Cross Country Healthcare, “We know that crisis such as this one are known to increase mental health and addictive disorders, however the unprecedented and widespread impact of COVID-19 on our finances, social isolation, economic turmoil, and our health will lead to an increased need for behavioral health.”
While the mental health effects of COVID-19 have clearly impacted the general public, there are also segments of the population at even greater risk. This is true of the one in five U.S. adults who already have mental health conditions, the millions of Americans with opioid use disorders, those struggling with alcohol and other substance abuse, and certain demographic and geographic factors. Perhaps one of the groups at most risk is our healthcare providers on the front lines.
“We have already seen that many of our own healthcare providers are vulnerable to emotional distress right now, given their risk of exposure to the virus, concern about infecting and caring for loved ones, shortages of personal protective equipment, longer work hours, and the emotional toll of caring for sick or dying patients,” says Drummond.
Increased Need for Virtual Behavioral Health Services Today.
There are many signs that the COVID-19 pandemic and nationwide lock-down is driving more mental health services online. At Kaiser Permanente, over 90% of mental health visits are now happening virtually. Doctor on Demand said it has seen a 130% increase in behavioral health visits compared with the same time last year. NOCD, an app-based provider specializing in obsessive-compulsive disorder, said virtual visits have more than doubled since the beginning of March.
“There is little question that America has become a nation desperately in need of virtual therapy,” says Drummond. “However, this growing demand is putting strains on the health care industry trying to play catch up in the use of telemedicine for behavioral health services.”
Adopting telehealth will likely be a tremendous paradigm shift for behavioral health providers, including psychologists, psychiatrists, licensed clinical social workers and licensed practicing counselors, among others. While years of restrictive federal and state policies kept therapists from adopting telemedicine, the Trump administration has temporarily eased some restrictions to make it easier for behavioral health professionals to video chat with patients – and states and insurers have followed suit.
“As more health care systems, hospitals and online mental health companies experience a massive surge in behavioral health services, we believe many will need to meet that demand by introducing new services, accelerating the opening of such services, and bringing more behavioral health professionals on board,” says Drummond.
Long-Term Need for Behavioral Health Post-Pandemic.
Researchers are warning that the COVID-19 pandemic could inflict long-lasting emotional trauma on an unprecedented scale and leave millions wrestling with debilitating psychological disorders. According to Drummond, “Given the combined stressors – the global nature of the pandemic, the isolation and social distancing, unemployment, and impending recession – it appears that long after the acute health effects on the population subside, we will see lasting effects in the form of increased demand for behavioral health services.”
Meanwhile, there have been barriers in the past that have limited access to behavioral health services. For example, in 2018, among the 6.5 million nonelderly adults experiencing serious psychological distress, 44% reported seeing a mental health professional in the past year. Compared to adults without serious psychological distress, adults with serious psychological distress were more likely to be uninsured (20% vs. 13%) and be unable to afford mental health care (21% vs. 3%).
One of the biggest factors contributing to limited access to behavioral health is a current shortage of mental health professionals, which will likely be exacerbated by the COVID-19 pandemic. The recently-passed Coronavirus Aid, Relief and Economic Security Act may help address the increased demand for behavioral health by including a $425 million appropriation for use by the Substance Abuse and Mental Health Services Administration among other provisions.
A lack of behavioral health professionals is most pronounced in rural communities in the U.S. In fact, the U.S. has an average of 30 psychologists per 100,000 people and 15.6 psychiatrists per 100,000 people. Yet, over 115 million people in the U.S. live in designated Health Professional Shortage Areas where the ratio of mental health professionals to residents is smaller than 1 per 30,000 people.
“We must begin to prepare and plan for a long-term demand for behavioral health support by ramping up hiring of professionals, increasing the use of locum tenens particularly in rural areas, and improving our telehealth capabilities to deliver these much-needed services,” says Drummond.