By EWA MATUSZEWSKI
“Virtual behavioral health visits fail to meet the needs of patients.”
Wow. Pretty strong positioning statement, don’t you think? And yes, I wanted to catch your attention. Alarming media reports over the past month have noted that certain online mental health providers were quick to prescribe medication for mental health treatment – sometimes with tragic consequences – when talk therapy may have sufficed. But it’s not a one-sided story and I think the statement is worthy of close examination. Frankly, I both agree and disagree with it.
First, one must look at life prior to the inception of virtual visits. How many people who needed behavioral healthcare did not receive it due to the stigma associated with behavioral health? From embarrassment, fear of being seen leaving a clinic, the lack of a trusted clinician provider to confide in – or simply the failure to recognize and prioritize how vital mental health is to overall health – the reasons for in-person treatment reluctance or avoidance abound.
Access to care has been a buzzword for years in healthcare, and the accessibility that comes with virtual visits cannot be denied, with clinicians able to see a greater number of patients regardless of location. Now, people can use their lunch break and have an appointment in their car; or while at home when their baby is sleeping; or in the middle of the night, when troubling thoughts need immediate, life-saving attention. Access is especially important in underserved, rural or remote areas. Several of our organization’s behavioral health specialists who live in Southeast Michigan have done virtual visits with people who live in the Upper Peninsula, an area woefully lacking in mental health providers and related resources.
So, yes, there are many virtual behavioral health benefits that can’t be overlooked. I might add that the proliferation of online health providers during the pandemic also served to draw attention to the need for better mental health services. Yet I caution that a profit-first approach to mental health care can – and indeed has been proven to be – dangerous on rare occasion. The opportunity for medications to be prescribed in a “cold call” fashion in what may be deemed a transactional setting is not only harmful but seems inherently wrong.
My overarching concern with virtual behavioral health when in-person care is available, is that it can put patients at a disadvantage by eliminating one of the greatest tools clinicians use in treating mental health disorders: social Interaction. In person, clinicians have genuine eye contact and can truly observe body language; there is also the opportunity for a handshake, a compassionate touch. One of the biggest problems facing society today is the excessive amount of screen time and ensuing loss of human contact. We have become so dependent on the virtual world to meet our personal and work life needs that we are losing our ability to connect with others in a sustained, meaningful way.
Social interaction allows for better mental health (it can lighten your mood and make you feel happier); lower your risk of dementia (social interaction is good for your brain health); and promote a sense of safety, belonging and security that allows one to confide in others and lets us confide in them. In an increasingly virtual world, we now confuse nervousness when we interact with others as anxiety. Persons of all ages see their behavioral health specialists in the same room where they isolate themselves to play video games or scroll incessantly over social media posts of others appearing to have ideal lives and are left to wonder, “Why am I am depressed?”
Let’s keep virtual behavioral health an option, but let’s also understand its limitations and seek whenever possible and pragmatic to provide better access to in-person care. Our nation’s health depends upon it.