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Community Mental Health - Millage News

Posted on: October 26, 2020

COVID-era telehealth expansion brings both improvements and challenges

Photo of doctor, holding a phone and waving at a telehealth client she sees on the screen

The coronavirus pandemic has created hundreds of complicated challenges--from an increased strain on the U.S. Postal System to delays in needed health care services. But the coronavirus pandemic has also spurred solutions, including a dramatic uptick in telehealth, the use of technology to offer health-related services such as therapy and to share health-related information such as lab results. 

Doctors can have video calls with patients to discuss concerns and utilize patient portals to send reminders, prescription information, health education, and information on lab results allowing with little to no in-person contact. This model works especially well with mental health care. 

Washtenaw County’s community mental health agency has embraced telehealth throughout the pandemic to provide ongoing care to its clients. Prior to the pandemic, WCCMH used telehealth in less than one percent of cases. By June 2020, 44 percent of the community mental health providers surveyed were using telehealth to reach and engage residents. 

The most frequent telehealth services being used include psychiatric medication reviews, targeted case management, and crisis interventions. Such meetings, alongside individual and family therapy and mental health assessments, are done mostly via phone or through a video conference call. 

Two in every five of the local community mental health providers surveyed (22 percent) said telehealth made them more effective by removing all-too-common barriers to care like transportation and scheduling issues. And nearly half of the providers surveyed (46 percent) said telehealth was as effective as face-to-face treatment.

But telehealth comes with a few challenges of its own. Roughly one-third of the providers surveyed (32 percent) reported that telehealth made them less effective. 

While some providers were able to accomplish more work in a smaller period of time and to help clients overcome typical access challenges, others worried that it was difficult to build rapport without face-to-face visits and that the upfront time required to get a telehealth system up and running was challenging. Providers also reported that they had to base physical assessments on verbal cues from their clients and that internet connectivity was a challenge.   

Patients who now rely on telehealth to talk to their providers, on the other hand, report that this new system is much more convenient for them. There is no need to travel to an office and calls can be done from the comfort of their own home. 

While some argue that overreliance on telehealth is not sustainable in the long run because of the lack of rapport, and the inability to care for more severe mental illnesses, it is improving access during a time of need and, if continued, will be a more convenient option for clients and providers into the future. 

--By Emmen Ahmed, MPH candidate, University of Michigan School of Public Health


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