The Expansion of Mental Health Services During the Pandemic

Hi, I'm Dr. Jameca Cooper, and today we're going to talk about how mental health services have been expanded during the pandemic. And I'm going to talk about 3 specific areas. I'm going to first start off by talking about EAP programs, then telehealth,, and then I'll finish by talking about demographics. So EAP programs— EAP stands for Employee Assistance Programs. So these are the programs that businesses or organizations have for their employees that allows them to get counseling or therapy services. You have to be first credentialed by that particular EAP program as a provider so that when the employee needs assistance, they simply go through their HR department or their EAP department, and then from that, they pair them up with counselors or therapists who can provide the services they need. The great thing about it is it's set up already by your employer, and the other great thing about it is it gives you a set number of sessions in order to at least start your therapy journey. It used to be that EAP services would only give you one session 2 sessions, maybe even 3 sessions. But the beauty that I've seen through the pandemic is that EAP services have expanded all over the country. So now they're giving their employees a minimum of about 3 to 5 sessions. So I think that's great because if you're an individual suffering from anxiety, you're going to at least need to start with a therapist for 3 to 5 sessions. So I think that has been one of the great advantages of the pandemic. The second thing I want to talk about is telehealth services. Pre-COVID, it would be very difficult, depending on which state you live in, um, to receive telehealth services from a psychologist or a counselor. But now, because of COVID-19 and the expansion of these services, which started with Medicare, then through Medicaid, and, and also through commercial health insurance providers, it's been great. As a psychologist that's been practicing for about 20 years, I'm excited and happy that everyone is finally catching up to the need for telehealth services. So telehealth can be in the form of audio and video. So it can be through certain platforms where I simply call my patients, they pick up, and I can see and hear them, and it's almost like Zoom or FaceTime. However, the platforms that I use as a psychologist are very secure and HIPAA compliant so that the data is, is held very safe and secure. Um, the other type of telehealth services would be phone services. So there are some insurances that approve me to be able to see my patients just by simply calling them on the phone for audio services. So again, I'm quite thrilled about these because there are many people in our society that can only see a therapist or counselor by one of these two ways. So let's talk about some of the benefits and the barriers to telehealth services. One of the huge benefits of telehealth services is that it improves access. So maybe prior to COVID, if you were an African American, um, teenage girl living in rural Michigan, you might not have had providers in your rural area that looked like you that you might have wanted to see. But now because of the expansion of services in telehealth, you could potentially reach out and see a provider in the Detroit, Michigan area, um, that would be of the demographics of your choice. Or you could see a provider in Atlanta or Chicago or St. Louis. So it's really improved access, and that has been a great thing for mental health services. One of the other benefits of telehealth services would be that it allows us to reduce or mostly eliminate the risk of COVID-19. So pre-COVID, my patients will come into my office to see me, or I would see them in their homes or nursing homes. But now we can simply log on to the platform, have our video sessions, and we don't have to worry about wearing masks or being socially distant, but we can simply carry on our session and not have to worry about contracting COVID-19. So that has been excellent. During the pandemic. One of the other benefits of telehealth services has been reducing the need for childcare. Prior to COVID, many of my patients that had small children, babies or toddlers, were always worried about who would take care of their child long enough that would enable them to come to see a therapist. So right now that's not an issue because with telehealth they can simply log on, have their session, and still be within range or in the same room of their child, and that will be another thing that they don't have to worry about. Another benefit of telehealth would be that it reduces the reliance on facilities. So now there are practitioners out in this world like psychologists, social workers, or counselors that don't have to lease office space. They don't have to have a brick-and-mortar office because they can operate a, an entire practice based on telehealth services. That's been great because it has allowed more practitioners to be able to provide more services. Now I want to focus a little bit on the barriers of telehealth services. So anytime you have an option that has benefits, it would also have barriers. One of the barriers that I see with telehealth services, especially since I work with older adults, is their familiarity with technology. Many of my older adult patients have no idea what I mean when I say telehealth. Many of them are not familiar with how to use programs and software. Um, when you think about using words and phrases with them like logging in, um, creating accounts, setting up programs, these are all things that are quite foreign to many of them, so they don't understand how to quite use it. That would be a huge barrier for this particular population. Another barrier could be internet service. Since we've been at home during the pandemic, you, if you watch the news, you notice that one of the things they were saying early on during the pandemic was that people were all on the internet. So it required that if you were working from home, you had to increase your internet service so that you had more bandwidth, faster speeds, more memory, all of that. But many of my older adult patients don't have internet services, or if they do, they really only have the basic services. If you have basic internet services, it could be hard to stream and do video, watch movies, and those things of that nature. So technology can be a huge issue, and internet services can be a huge issue. Um, another one of the barriers for telehealth services could be Having a smartphone or a tablet. I think many of us in a certain age group assume that everyone has a smartphone, laptop, or tablet, and that is not true at all. Most of my older adult patients have no smartphone whatsoever. In other words, they have no way to log into their phone to do many of the things that you would do on a regular computer. So it's very difficult for them to be able to do telehealth without having a smartphone or a tablet. One of the other barriers to telehealth services would be privacy issues. So although I said earlier that it could be easier for a mother with a small child to have her therapy session while being within range of her small child, it could also be a privacy issue because what if her spouse is in the same room or the next room? What if her, her mother, her mother-in-law, her other children are also within range? It could be an issue as far as confidentiality and this person being able to feel secure and that their issues are going to be held in a confidential nature. The last factor that I want to talk about today would be demographic preferences. One of the great things that have occurred during the pandemic is that individuals now have a bigger desire to enter therapy, which has been great for the field, but it's also made individuals have more of a focus on the demographics of their provider. So now, instead of pre-COVID where people would just be happy to have a counselor or a therapist, now individuals are more interested in what this provider looks and acts like. So now it could be a white male in rural Missouri that is homosexual that has not been able to find a provider in his area. Because it's a rural part of Missouri. Now, because of access of things like EAP and telehealth, now he can seek out a provider that has the same values that he has, and he can enter into a therapy situation and now feel more supported and safe. So demographic preferences are now, um, a priority for many individuals who are interested in therapy. And I think as a provider that that has been a really good thing. I don't see anything wrong with wanting to have a therapy provider that looks like you or that has values such as yours, because we wanna make sure that individuals can access therapy and enter into a therapeutic relationship where they feel supported. Today, we've talked about a few different reasons why mental health services have been able to be expanded during the pandemic. If you're interested in hearing more about mental health services during the pandemic and beyond, please tune in and subscribe.