As part of our ongoing #NYCHBLeaders series looking at COVID-19’s impact on NYC, we hosted a virtual discussion on July 15th: The Coming Mental Health Tsunami. Led by NYCHBL president Bunny Ellerin, the hour-long conversation included Gil Addo, CEO of RubiconMD; Samir Malik, SVP of Genoa Telepsychiatry; and Dr. Reena Pande, Chief Medical Officer of AbleTo.
Telehealth continues to reshape mental health access and delivery as a result of the global pandemic. Here are key insights from the wide-ranging discussion. You can also watch the video of the full discussion here.
1. The COVID era has exacerbated the mental health crisis but supply still lags behind demand
The number of patients seeking mental health treatment has spiked in response to the global pandemic and focus on racial injustice. Isolation, fear, and anxiety have become commonplace for Americans as both unemployment and infection rates continue to soar. With the rise in mental health cases, the shortage of providers has been magnified.
Demand has increased, but fundamentally the problem we had before COVID was that there was inadequate supply in the marketplace. COVID did not suddenly create a supply of new therapists, psychiatrists or nurse practitioners. – Samir Malik
2. Telehealth has increased access but not equitably, particularly in Black and Brown communities
Since the arrival of COVID-19 in early March, telehealth professionals have responded to major shifts in demand and accessibility. Long sought-after regulatory changes from CMS were enacted on an emergency basis to expand site of care to the home, relax HIPAA requirements for certain online tools, and increase the number of reimbursable telehealth services. These led to an explosion in virtual mental health visits, but not in all communities. All three of the leaders highlighted the lack of telehealth and mental health resources within the most vulnerable communities, stemming from long-standing health, policy and structural inequities. Safety net clinics were often the most underserved, leaving the same communities where COVID had the greatest impact without care.
COVID hasn’t impacted communities homogeneously. There are clearly communities that have been harder hit, specifically Black and Brown communities. – Gil Addo
3. Primary care and behavioral health must be integrated for patients
All of the panelists emphasized the importance of integrating mental care with physical care, citing the need to offer a complete solution to high-risk patients. Primary care doctors, however, often have little experience managing psychiatric conditions. Recognizing this gap, RubiconMD has partnered with both AbleTo and Genoa to create tailored programs to educate PCPs..
As a cardiologist, I saw firsthand in my clinical experience how much depression, anxiety and other mental health challenges were a barrier to accomplishing all the things we were trying to do on the physical health side. – Dr. Reena Pande
You can’t divorce behavioral mental health from physical health because it’s so tightly integrated in the way in which people need to be served. – Gil Addo
4. The number of point solutions continues to expand but the future will be about creating integrated, targeted programs
With more attention being paid to behavioral health, new entrants are moving into the space with sizable funding. They often targeting specific areas like addiction or depression. But payers are growing frustrated with the sheer number of products and services. They would prefer a unified solution.
The space has exploded introducing a plethora of solutions. It’s hard for clinicians, it’s hard for the patient, it’s hard for employers and it’s hard for payers to sift through all of them. The onus is on folks like us to put the puzzle pieces together in a suite of solutions to help solve the problems. – Dr. Reena Pande
5. Action is required from all of us to make mental health a priority
While mental health is no longer the taboo it once was, there is still lingering stigma. Our panelists suggested that consumers have a voice and should engage.They should talk to their employers and urge benefit teams to make sure employees are aware of the resources and feel comfortable accessing them.