The widespread adoption and expansion of telehealth in primary care and behavioral health occurred rapidly as a means to provide continuous patient care during the COVID-19 pandemic. Telehealth implementation continues to change and evolve rapidly, particularly as it relates to policies, payments, regulations, and laws. In order to provide patient-centered, integrated behavioral health care in primary and ambulatory care practices, those actively involved in behavioral health integration must stay current with these changes, with particular attention to the importance of adapting telehealth options to the needs of patients, providers, and care teams.
Self-help technologies
Many mental health apps and self-directed approaches provide quick access to some form of mental health help. Limited access to mental health professionals is often used to explain why fewer people receive treatment. But it's important to recognize that many people do not seek traditional mental health treatment, even when it is available.
Self-help strategies can help people with mild mental illnesses and promote overall well-being. Additionally, several recently developed and FDA-approved apps offer clinical depression psychotherapy for mental health conditions.
Many people already use tracking devices to track health information about sleep, activity level, and mood. Although still in the early stages of development, some technologies also use facial expressions and outcomes to alert an individual or a doctor to an improvement or deterioration in their mental health. This can help them access care or make lifestyle changes before a crisis.
Automation and decision support
The foundation of integrated behavioral health services is universal screening for mental health, substance use, and social determinants of health needs. Exciting technological advances are helping to automate this process. Positive screening should serve as an entry point to provide active outreach to help patients access care.
Patients who test positive for depression receive help from members of our behavioral health integration team. We offer them access to a clinical evaluation and possible treatment, along with other resources.
For doctors, decision support is another key advance. Within electronic health records, treatment resistant depression modules are available for common mental health conditions to assist providers. Technology is included to assist with provider-to-provider consultations, such as eConsults. These innovations can provide immediate help to patients and doctors without the need for an in-person consultation, which could reduce wait times for specialized mental health services.
Telehealth to implement integrated behavioral health
Telehealth involves the use of telecommunications and electronic information technologies to support the delivery of clinical services, health-related education for patients and professionals, public health, and health administration. These technologies may include hardware (e.g., phones, smartphones, tablets, computers, kiosks, wearable devices, and patient testing and monitoring devices) and software (e.g., computer programs, online platforms, and mobile applications).
Implementing integrated behavioral health care into primary or outpatient care practices using telehealth technologies can provide patients with greater access to substance use, mental health, and recovery support services. Telehealth policy changes enacted in response to the COVID-19 pandemic have expanded guidance, coverage, and flexibility for the use of telehealth in primary and behavioral health care practices.
Additionally, care models for behavioral health integration can be implemented in whole or in part using telehealth technologies, depending on the needs and resources of patients and practices. The evidence base for using telehealth technologies for behavioral health integration, although limited, is promising, with high patient preference and outcomes comparable to in-person care.
What are the benefits of integrated behavioral health care?
Improved access to care: Integrated behavioral health care can improve access to mental health services for people who face difficulties seeking or obtaining behavioral health services due to various factors such as stigma, limited transportation options, or a lack of insurance coverage.
Better coordination of care: Integrating mental health services into primary care settings facilitates more coordinated and comprehensive care, with primary care and mental health professionals collaborating to address physical and mental health needs.
Better health outcomes: Studies have shown that integrated behavioral health care results in better health outcomes, such as better management of chronic diseases, decreased hospitalizations and emergency room visits, and better overall quality of life for patients.
Increased patient satisfaction: Patients often express high satisfaction with behavioral health care, such as increased comfort, reduced stigma, and improved communication between healthcare providers.
Decreased healthcare costs: Integrated behavioral health care has the potential to reduce costs for patients, providers, and health plans by improving the management of chronic conditions and minimizing unnecessary medical procedures and hospitalizations.
Who can benefit from integrated behavioral health?
Integrated behavioral health can benefit people experiencing behavioral health, mental health, and/or substance use issues.
Children and adolescents:
Children and adolescents can benefit from behavioral health care, particularly in school settings. Early intervention services and prevention programs can help identify and address mental health problems before they worsen. This, in turn, can improve school performance, promote healthy development, and decrease absenteeism.
Adults:
Integrating behavioral health care can benefit adults with a variety of mental health and substance use disorders, such as depression, anxiety, and addiction. Patients can benefit from a team-based approach to care that includes primary care physicians, psychiatrists, therapists, and support for lifestyle improvements to improve an individual's overall health and well-being.
Older adults:
Older adults may benefit from behavioral health care to address age-related mental health issues, including dementia and depression, as well as physical health issues that can impact mental health, including disability and chronic pain. Additionally, older adults may benefit from interventions that promote social connectedness and reduce isolation.
How do I access behavioral telehealth services?
Many behavioral health care providers now offer telehealth for outpatient services. Talk to your best telehealth services for mental health provider about your telehealth options and whether virtual care is right for you. Patients who are eligible for telehealth care may still face difficulties.
