Sunnier days ahead: the future of telebehavioral health

Prior to COVID-19, telebehavioral health (TBH) was considered inferior to in-person therapy due to misinformation, regulatory, geographic, and reimbursement challenges. As a result, access to TBH faced significant obstacles.

However, the acceptance and availability of TBH has vastly improved in recent years due to several societal changes.

 

The pandemic as a catalyst

 

COVID-19 served as a driving force to change life as we know it, and behavioral health is no exception. The pandemic created a mental health crisis in need of innovative solutions, and TBH has helped to successfully fill the void left by the crisis, changing TBH’s reputation for the better.

Virtual appointments became a new, attractive option. A national study including 36 million working-age individuals on private insurance indicated telehealth encounters increased 766% in the first three months of the pandemic — from 0.3% of all interactions from March to June 2019, to 23.6% of all interactions in the same period in 2020.¹

 

Loneliness and sheltering in place

 

While everyone experienced sheltering in place and lockdowns differently, many endured extreme loneliness and isolation, particularly if they lived alone. For those already struggling with mental health issues, their struggles were exacerbated in these new, unfamiliar times. Furthermore, even as the world started to open again, people had continuing concerns over COVID-19 and masking.

 

Shortage of mental healthcare providers

 

The availability of mental healthcare had already been an issue prior to the pandemic, and it further heightened during and after COVID-19 due to unprecedented demand. The shortages in mental health services now impact an estimated 132 million Americans. More than 6,600 mental health practitioners are needed to fill vacancies.²

 

Affordability, convenience, and privacy

 

TBH has typically been more affordable than traditional, in-person therapy — now reimbursed at higher rates than ever before. Additionally, patients who opt for TBH do not need to absorb the costs of travel, child care, or lost work hours. Furthermore, the convenience and flexibility of TBH opens additional timeslots for many individuals, allows people to access TBH in the privacy of their home, and helps reduce any associated stigma.

 

Changes in the telebehavioral health sector

 

While these societal forces have combined to make TBH an increasingly popular, growing option, the TBH sector continues to mature and adapt.

 

Rollout of 988

 

In July 2022, the 988 Suicide and Crisis Lifeline launched as a 24/7 emergency crisis care system, providing direct, life-saving services to anyone in need. 988 offers call, text, and chat access to trained counselors for people experiencing suicidal, substance abuse, or any other type of mental health crisis.

 

Regulatory and reimbursement changes

 

Key regulatory changes further improving the quality and efficiency of TBH include easing HIPAA requirements for videoconferencing,³ lifting some of the restrictions preventing providers from prescribing medications via virtual sessions,⁴ and continuing to improve reimbursements for TBH sessions.⁵

 

Improved training

 

As TBH has become a more viable and sought-after option, TBH provider training programs have been implemented, with particular focus on serving vulnerable populations, diverse communities, and handling substance abuse or opioid addiction issues.

 

What lies ahead in telebehavioral health

 

While traditional face-to-face therapy sessions will continue to be the preferred option, TBH is now a valid alternative to in-person therapy. We can expect to see the TBH sector continue to evolve in several ways in the next few years, such as policy changes allowing for more reimbursement, including that of Medicare.

Additionally, providers will continue to meet patients halfway with convenient options, which will in turn allow for better clinical outcomes.