Barriers begone: How virtual behavioral health is changing the access equation

Our nation’s behavioral health statistics are grim. Conservative estimates show that nearly a quarter of US residents experience some form of mental illness each year, including 5% of adults and 13% of youth experiencing thoughts of suicide.  

Almost 20% of adults had a substance use disorder in 2023, yet 77% of them are not receiving any treatment. With more than 340 people for every behavioral health provider in the US, that comes as no surprise. 

The staggering imbalance between the need for behavioral healthcare and the resources available to patients has created enormous barriers for those in desperate need of support.  Hundreds of geographical areas, including 75% of rural counties, have no psychiatrists, psychologists, or counselors at all, leaving people with nowhere to turn when life throws them a curve.  

Enter virtual care. Emerging as a hero during the pandemic, virtual behavioral healthcare platforms have continued to flourish as patients, providers, and payers all acknowledge the benefits of separating high-quality care from the physical world. 

But delivering on the promises of virtual care isn’t as easy as sending patients a Zoom link instead of asking them to drive to the office. The uneven distribution of resources, along with the imperative to thoughtfully match individuals with the right providers for their needs, means that virtual behavioral healthcare must be built on digital platforms that can solve a variety of administrative and technical problems. 

From presenting accurate provider information and reducing the time-to-treatment to coordinating with clinical members of the care team and measuring the quality of their services, virtual behavioral health companies have plenty of their own challenges to address as they work to reduce barriers for patients.  

Making the perfect pairing between patient and provider

For most patients, finding a provider that takes any insurance (let alone the right insurance), who is accepting new patients, specializes in the right area, and meets the right demographic criteria, is like searching for a needle in a haystack.  

It gets even harder when information on payer websites or search engines isn’t up to date, noted Cynthia Grant, Head of Clinical Excellence at Grow Therapy, a nationwide platform with more than 8000 available therapists and over 50 health plan partners. 

“Payer directories are notoriously difficult to keep updated because of the sheer volume and frequency of changes that occur within a provider network,” she said. “Patients are sometimes left wondering who’s available and if they can actually get an appointment that’s going to be covered by their health plan. It benefits everyone to make sure that provider information is accurate when patients are seeking a new relationship.” 

To solve for this issue, Grow Therapy partnered with Kyruus Health, which makes data-driven connections between providers and payers to ensure that consumers can find accurate information on available services. 

“Patients typically look for providers in one of three places: their health plan’s website, their health system’s website, or Google,” explained Gail Airasian, Chief Strategy Officer at Kyruus Health. “We’ve found that all three have trouble with providing insight into the clinical and demographic attributes most important to patients due to the way services are tagged internally and then surfaced by search algorithms. That’s what we’re working to solve with better algorithms and digital efficiencies.”   

“The more we can use technology to streamline and personalize the experience of selecting an appropriate provider, the better the match is going to be, which makes it more likely that the patient will have a positive experience with their treatment,” she said. 

Providing the tools for a successful, synergistic relationship

 “Personalization” is a buzzy term across all of healthcare, but it might be most important in behavioral healthcare, where patients must feel comfortable revealing intimate details of their lives in order to receive therapeutic benefit. 

The imperative to foster openness and trust in a truly patient-centered manner is one reason why specialty behavioral health platforms are also seeing great success in the current environment.  

“Patients need to know that their providers have the experience, the passion, and the investment in the things that matter most to them,” said Sipra Laddha, MD, a reproductive psychiatrist who co-founded LunaJoy, which focuses on reproductive, pregnancy, and postpartum behavioral healthcare. 

“And practitioners want an opportunity to develop those passions and skills, as well. The pregnancy and postpartum population is not something that’s stressed very strongly in training or residency, but approximately a quarter of all preventable post-partum deaths are due to suicide or substance abuse, which can be treatable. Providers are actively seeking more hands-on experience working with these individuals so they can provide better care overall.  It’s just another barrier that we can knock down for everyone using virtual care techniques.” 

Reducing time-to-treatment at critical junctures in the patient journey

Behavioral healthcare is often time sensitive. People may be most likely to seek services when they actively in crisis, but they’re also likely back away from connecting with a provider if they feel ignored in their time of need or think they’re getting better on their own once the immediacy of the situation has subsided.  

“The most important thing we can do with remote care is remove the barrier of actually being able to get access to services when you need them,” stressed Grant. “We don’t want someone to have to call someone a hundred times or wait three months for a first appointment. We need to capitalize on that vital moment when a person is energized to make a choice that could improve their lives, and virtual care is the best way to get them where they need to be quickly and without the challenges.” 

This is especially important during a time-bound episode like pregnancy and post-partum care, added Laddha. 

“I had my own high-risk pregnancy journey with my twins. While my providers could tell me exactly what my cervix was doing at any given moment, they never gave me a single mental health questionnaire. When my OB finally screened me post-partum, I screened very, very positive for certain issues,” she said. 

“Asking patients to wait another six months to connect with care at that point is just not acceptable. This is such a vulnerable moment in time for many people. It makes a ton of sense to use technology to meet people where they’re at in their journey.”  

Virtual platforms have had notable success with reducing wait times. For example, Grow Therapy has no waiting list for care, and the average patient can be seen within two days of reaching out. And LunaJoy offers 24/7 access to its care navigation team so issues can be addressed quickly if they arise during the therapy process. 

Extending the impact of virtual care through collaboration and quality measurement

Historically, behavioral healthcare has existed in its own universe, separate from the clinical team. Virtual platforms are aiming to change that by bridging the gaps that have led to fragmentation of services. 

“Our technology platform allows us to share notes between the therapists, psychiatrists and other providers we have at LunaJoy so everyone stays on the same page,” said Laddha. “We also have EMR integrations with clinical partners so we can close the loop with OB/GYN and primary care providers, as well as communication pathways with care coordinators and case managers, so we can be more fully integrated into the broader care team.”  

This type of standardized, data-rich integration is crucial for measuring the impact on behavioral healthcare on overall outcomes, which is a skill the healthcare system has thus far underdeveloped, said Grant. 

“In addition to creating a system that allows access to care, we also need mechanisms to measure the quality of those services,” she said. “As we move more toward value-driven models, we have to connect the dots and generate outcomes data that provides quantitative insights into what therapies are effective and how to choose the right tools for working with individuals and populations.” 

“That’s one of the biggest and most exciting frontiers in the health tech sector. Improved quality measurement could set more standardized expectations for treatments, reduce stigma, and offer a better idea of what quality looks like so we can focus our spending and resources appropriately. The ‘art’ of therapy will always be important, but incorporating more of the data science piece will elevate the profession even further.” 

It’s all part of the push to personalize the delivery of the right care at the right time in the right modality so that patients – increasingly morphing into consumers – can see meaningful benefits from participating in holistic care.  

“Personalization is the future of virtual care,” stated Laddha. “If I think about three to five years from now, I envision AI-driven solutions that are much more proactively informed by past medical history, risk scores, and other data that can target care and encourage better outcomes.”   

“Behavioral health can be part of preventative care if we’re creative enough about using technology to make it happen. I’m looking forward to the time when patients are more frequently proactively offered virtual behavioral health services that are optimized for their needs via a platform that is fully personalized and fully integrated into the broader care continuum.”   

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.