89% of UK patients get appointments within 90 days of referral to mental health services. What if there were a less expensive way to reach more patients in less time? Is telehealth psychology's best-kept secret?
Imagine that your marriage is on its last legs.
Or you are so stressed about your job (or lack thereof) that you’ve not been able to sleep for more than an hour at a time for weeks.
Maybe you’re addicted to alcohol or drugs.
Perhaps you just can’t seem to stop eating thousands of extra calories each day in licorice and French fries.
Now imagine that you finally decide to ask for help—only to find that you’ll be put on a waiting list and the typical wait is anywhere from 28-90 days.
The NHS reports that treatment began for 61% of referred patients in 2013-2014 within the first 28 days, and 89% were treated within 90 days. While about a month may not sound like a long time to wait, when it comes to mental health, every moment can count.
Partly as a result of cumulative budget cuts of nearly 6% since 2010, getting help for your children may be difficult at best. In order to have a referral accepted by a mental health agency, according to an anonymously written article in the Guardian last week, you’d need a diagnosis. Bereavement, potential bullying, and trouble at school—none of these will get your child or adolescent onto a therapist’s couch, according to the article.
One in four
And it’s not a small problem.
One in 4 British adults will experience mental illness in any one year, according to the Office of National Statistics Psychiatry. As I’ve written previously, 1 in 4 people globally will experience mental illness in their lifetimes.
Mental health matters but the world has a long way to go to achieve it. Many unfortunate trends must be reversed[…, including] neglect of mental health services and care,
according to the Director-General of the World Health Organization (WHO), Dr. Margaret Chan.
Psychology’s best-kept secret
What if there were a less expensive way to reach more patients in less time?
For years, psychologists have been studying the effects of telehealth-enabled counseling. Over a decade ago (in 2001), a national survey of Australians found that telehealth consults increased access to mental health services for previously underserved populations, particularly those living in rural Australia.
Despite its apparent efficacy, only roughly 7 percent of Canadian psychiatrists reported using telehealth or video conferencing to evaluate patients in a government-funded survey conducted in 2003.
Psychological associations around the world have developed careful guidelines about the administration of telepsychology services, including the American Psychological Association and the New Zealand Psychologists Board. Studies find that, despite possible wariness on the part of the psychologist, remote therapy using telecommunication technologies (email, texting, video conference, telephone, etc.) are frequently as effective as more traditional in-person therapies. So, what gives? Are telepsychology services psychology’s best-kept secret?
While reimbursement debates prevent many US practitioners from signing on, over the last several years, many of these restrictions have been lifted in the EU. While reimbursements may be available, and there is certainly the need for better access and more providers, it seems that tech-enabled counseling is still off-putting for some.
A Guardian article published last month discussed ways in which technology may help alleviate some of the backlog of mental health cases in the NHS. Contributor Sarah Bateup, a clinical lead at Ieso Digital Health, implored:
Let’s stop wasting resources by keeping people waiting and leaving them to suffer because we tell ourselves it is too difficult to expand access – it isn’t.
The response to Bateup’s article was mixed at best.
"Computerised CBT is wierd - although it may work. Talking to a therapist by computer, not so much.” – Mazy, Guardian commenter
Lu Frye, another Guardian commenter, was worried about privacy.
Ever since getting targeted advertising from Google related to searches I did for medication, it has become painfully aware to me that my browsing is logged, recorded and used commercially. Getting help online has dangers.
With the online chatter, combined with the prevalence of mental illness in the UK and the current waiting times, it seems like telepsychology might at least alleviate some of the pressure on the system, but may not be a one-size-fits-most solution.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.