As the U.S. health system continues to confront the growing number of COVID-19 patients, there is a mental health crisis that threatens to exacerbate the challenges health systems already face from the pandemic. With the rise in unemployment, isolation from social distancing, and general anxiety around COVID-19, millions of Americans are in critical need of psychiatric care but are delaying treatment due to the fear of contracting the virus. To combat this surge in psychiatric patients, hospitals and healthcare systems are relying on telepsychiatry and the solutions it provides.
Current Conditions and the Historical Challenges with Treating Psych Patients
It’s evident the coronavirus pandemic is having a significant impact on the mental health of Americans. Mental Health America has already seen a 20% increase in free screening tests for anxiety between mid-February through mid-March, and the helpline for Substance Abuse and Mental Health Services Administration received 8 times more calls and texts in the same period. Despite this sharp increase, a recent study by McKinsey & Company found that one in three respondents cancelled appointments due to COVID-19.
On the frontline, healthcare providers are noticing a similar pattern.
Kathy Rhodes, Director of Behavior Health at TriStar Health, experienced a 30% decrease in call volume and a 25% decrease in psychiatric patient visits in previous weeks. “Patients are delaying treatment, missing prescription refills, and holding out as long as they can,” says Rhodes, “but now symptoms have worsened and potentially require more acute and inpatient care.”
Treating psychiatric patients has historically been a challenge for healthcare systems and emergency departments for several reasons. One of the biggest obstacles patients’ encounter when seeking treatment for psychiatric symptoms is access to care. In fact, nearly 77% of U.S. counties face a serious shortage of board-certified psychiatrists. With nowhere else to turn, many patients visit emergency departments for treatment, resulting in one in eight visits relating to mental health and substance abuse issues.
The lack of access to psychiatrists and limited resources to treat psychiatric patients in emergency departments leads to long wait times for dispositions, with some averaging upwards of 23 hours. This long wait can result in poorer patient outcomes, leading health systems and providers to look for solutions to quickly triage patients and gain access to additional psychiatric support – solutions like telepsychiatry. “We’re relying heavily on telepsychiatry right now and getting creative with how we use it,” says Rhodes.
Here’s how telepsychiatry can address many of these challenges and prepare hospitals for the upcoming surge in psychiatric patients.
Access to Psychiatrists
The surge of psychiatric patients means hospitals critically need access to board-certified psychiatrists. However, there’s limited time to recruit, hire, and train new onsite psychiatrists, not to mention the cost of hiring additional full-time staff when budgets are already impacted by COVID-19.
Telepsychiatry provides hospitals and health systems access to psychiatrists across the country, regardless of location. The recent changes to telehealth legislation in response to COVID-19 also makes credentialing across state lines temporarily easier. “With the ease in restrictions, we’re able to really lean on remote psychiatrists to fill gaps in coverage across all of our locations,” says Rhodes.
Additionally, the cost of telepsychiatrists is significantly less than hiring full-time staff. For rural areas, where nearly 65% of communities lack access to a psychiatrist, telepsychiatry provides hospitals with access to parts of the country in critical need.
Patient Triage & Immediate Care
Delaying treatment for mental illness can exacerbate conditions, oftentimes requiring more acute care and inpatient hospitalization. With the volume of psychiatric patients, triaging low acuity patients can free up inpatient beds for those in critical need. Telepsychiatrists can screen patients remotely and recommend to onsite staff whether patients require hospitalization or can be discharged.
“Many patients come in in an acute crisis,” says Rhodes. “We use VirtualMed Staff’s telepsychiatrists to immediately get care to the patient, do an assessment, and get started with treatment.” Most telepsychiatry programs can accommodate a patient within one to two hours. The decreased wait time not only increases the likelihood of a positive outcome for the patient but increases the number of patients an emergency department can see throughout the day.
Time is of the essence for patients with exaggerated symptoms, and the faster they can receive medication the quicker those symptoms will subside. “Medication management is the biggest piece,” says Rhodes. “We don’t want to waste time and let conditions worsen, and without telepsychiatry we couldn’t immediately deliver medication and get started on active treatment.”
The American Psychiatric Association estimates the average psychiatrist spends approximately 48 hours a week at work, with 60% of that time treating patients. Even with multiple psychiatrists on staff, there are still gaps in coverage and the chance psychiatrists are unable to work shifts. Telepsychiatry services can provide 24/7 coverage to hospitals and emergency departments and fill in during an unexpected absence. “In the event a psychiatrist is out, we can use telepsychiatry to cover patient rounding,” says Rhodes.
The Importance of Telepsychiatry Moving Forward
With the surge in psychiatry patients, telepsychiatry expands the bandwidth of emergency departments to see more patients during this critical time. “It’s hard to predict, but we expect to see another few weeks of psychiatric patients rebounding to even higher amounts,” says Rhodes. “We know the patients are out there and haven’t been seen, but telepsychiatry and telemedicine have opened up possibilities to reach more patients.”
To learn how partnering with a telepsychiatry service can support healthcare providers and hospitals, schedule a demo here.