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05/28/2020

Telehealth Expansion for Mental Health Visits May Be Silver Lining of Pandemic

Telehealth Expansion for Mental Health Visits May Be Silver Lining of Pandemic
Written By: Alan Johnson, NAMI Ohio Contract Writer

 

The silver lining in the COVID-19 pandemic may be a dramatic increase in effective use of virtual or “telehealth” counseling and treatment for Ohioans with mental illness.

With psychiatrists and counselors unable to see most of their patients in person because of pandemic restrictions – and many patients leery about making office visits - there has been a huge surge in sessions using telephones and computers for virtual counseling.

Nationwide Children’s Hospital in Columbus did 80,000 telehealth sessions in the past two months, including 36,000 behavioral health appointments, the hospital told the National Alliance on Mental Illness of Ohio.

Akron Children’s Hospital, meanwhile, did about 100 telehealth mental health sessions with patients in all of 2019, but that number increased to 1,700 this year just in the month of April. Dr. Sarah Rush, chief medical information officer, said the hospital had about 10,000 total telehealth sessions for physical and mental health combined in March and April, a huge increase over last year.

Even better, clinicians say they are seeing improved interaction with patients. many of them children, through telehealth sessions compared to the standard in-office visits where patients were frequently less relaxed than in the comfort of their own homes.

The telehealth trend is happening statewide, as indicated by a recent survey done by the Ohio Department of Mental Health and Addiction Services of prevention, treatment, recovery support, housing, and other providers. About 70 percent of 534 respondents said they are offering telehealth services. The number was 80 percent for Medicaid providers, ODMHAS said.

The survey also found an increased level of engagement in services and a higher rate of patients keeping appointments. Telehealth seemed to work well in areas where transportation is an obstacle (such as rural areas), and gave clinicians “the ability to reach individuals where they are,” the state agency found.

Lori Criss, director of the Ohio Department of Mental Health and Addiction Services, said her agency began taking steps in March to move toward virtual sessions for patients. For patients, “It help them overcome some of their fears and anxiety about leaving home,” she said. “Providers have been thrilled with it.”

“We know it doesn’t work well for all services and for all people,” Director Criss said. “But having one more option is a great bonus.”

Dr. Mackenzie Varkula, a child and adolescent psychiatric specialist in Cleveland, said as the pandemic hit, “We had to make it work so we did.”
“My biggest fear was using telehealth for my younger patients,” she said. “But those are the ones I’m enjoying seeing the most in their home habitat. I’m able to see some kids in their own world who had refused to talk to me or were very hesitant.”

“It’s been eye-opening,” Dr. Varkula said. “I’ve learned a lot. Do we still need to see people in the office? Absolutely. But this really is working.”

Dr. Steven Jewell, head of pediatric psychiatric and psychology at Akron Children’s Hospital, said once the pandemic hit, the hospital was “struggling with patients who were reluctant to come in for services. For them, telehealth is sort of a natural. We can do almost anything we can do in person.”

“It’s like getting a little peek into their household,” Dr. Jewell said. “I even get to meet the family pets.”

He said mental health providers are changing their attitude toward telehealth after initially being negative, Dr. Jewell said. With only 8,000 child psychiatrists working in the U.S., telehealth can fill gaps, he said.

Everyone in the mental health system agreed the key to continuing virtual mental health coverage is how the service is reimbursed. Both the state and federal governments approved temporary waivers soon after the pandemic hit that allow care providers to be paid for telehealth appointments the same as in-person sessions. Regulations for prescribing medications were also temporarily relaxed.

Continuing those services once the COVID-19 pandemic is in remission will require action at both the state and federal level, particularly regarding Medicaid.

Director Criss said, “Our administration feels strongly that this needs to continue.”

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