As someone who has worked in the U.S. healthcare system for almost 30 years, I’ll be the first to admit that navigating the system is difficult.
For too long, that complexity has been multiplied for those seeking mental health care—compounded by rising costs, limited access points to quality care, and social stigma.
According to the National Alliance on Mental Illness (NAMI), 1 in 5 Americans suffered from a mental illness in 2018. That’s roughly 47.6 million people. Of that number, only 43.3% of U.S. adults with mental illness received treatment.
The COVID-19 pandemic has presented huge challenges for people’s mental well-being, negatively impacting individuals’ mental health and creating new barriers for those already suffering from mental health issues. As the U.S. becomes the undisputed epicenter of the crisis and social distancing measures roll on, we are all dealing with uncertainty, distress, and anxiety on an unprecedented scale. The stress of a business owner facing financial hardship; the loneliness of an elderly woman separated from their family; or the grief of someone who has lost a loved one.
NAMI has already reported that they’re seeing an increase in calls related to anxiety and depression during COVID-19, with many people worried about access to care and medications, and experts warn that social distancing and isolation are triggers for people with mental health issues.
We were already facing a mental health crisis before the pandemic. We need to act strategically and fast to ensure we can build resilience and limit the negative, far-reaching impacts of this crisis on our mental and physical well-being.
I see four priorities:
Breaking down barriers to care: We need to empower and equip trained counselors and psychotherapists to provide care.
Mental health providers are overburdened with complicated requirements by insurance providers to prove diagnoses and low reimbursement rates which disincentivize them from remaining in-network, increasing out of pocket expenses for patients.
We need strict government oversight to ensure insurance providers are covering mental health costs at the same rate as primary care costs as required by the Mental Health Parity and Addiction Equity Act and ensure that procedures imposed on providers are equal.
Community: We need to lean on each other and create safe spaces to discuss the challenges we’re facing. It’s important to talk with people you trust about how you are feeling. We can find strength in recognizing our shared vulnerability.
As Vivek Murthy, the physician and 19th general surgeon of the U.S. puts it, the pandemic gives us both “the prospect of a looming recession, but also the opportunity to reflect and reorient. It could trigger [...] a resurgence and a revival of social connections.”
Telehealth: We need to increase digital access points to high-quality counseling and psychotherapy to help everyone manage their own mental well-being. I’ve seen a number of companies step up to provide flexible, safe, and affordable care:
- Traditional brick and mortar practices like SMART recovery and Federally Qualified Health Centers are moving to telehealth services in order to continue providing care during this time.
- Big Health, a digital therapeutics company, is releasing free programming that uses cognitive and behavioral techniques to combat poor sleep and anxiety.
- At Hims & Hers, we recently started offering free group support sessions on the platform, connecting people in an online group setting with a licensed mental health professional via Zoom (chat or audio) to learn tools and strategies for addressing common concerns people are facing in the current climate. In the coming weeks, we will also be rolling out access to individual online therapy and comprehensive psychiatric evaluations.
Telehealth policy: A large number of state-level regulations have been adjusted to enable the virtual delivery of healthcare in most instances. For mental health care, the federal government has issued new regulations during COVID-19 to enable providers to conduct assessments over the phone in some psychiatric cases.
This is crucial during quarantine where many of those who struggle with addiction have few places to turn to following clinic closures. Looking past COVID-19, we need to equip providers with maximum flexibility around their ability to diagnose and treat behavioral health cases across state lines and remotely via telehealth to ensure everyone has access to quality care.
The COVID-19 crisis is unprecedented and has caused the lives of so many Americans to be upended. We are witnessing an escalation in societal and emotional crises and we’re nowhere near the end of this pandemic.
Telehealth has the potential to accelerate and deliver the necessary mental health resources we need at this crucial time, connecting people to high-quality care so they don’t have to suffer in silence. Telehealth must be at the heart of the national response to meet the social and emotional needs of the current COVID-19 crisis and aftermath.
Patrick Carroll, M.D., is the chief medical officer at Hims & Hers. Previously, he served as Walgreens' CMO where he led all clinical protocols and retail clinics.