Providing Better Mental Healthcare Post-Pandemicinfluence: the psychology of persuasion

Providing Better Mental Healthcare Post-Pandemicinfluence: the psychology of persuasionKey points The mental health care system was taxed prior to the COVID-19 pandemic and is at a breaking point. Graduate programs can meet the need for mental health providers through mentorship and recruitment programs. Expanding telehealth services can help underserved communities. Primary care providers can be trained to provide brief mental health screenings and targeted brief treatment.

Against the backdrop of global instability, nations are beginning to open their borders and reduce COVID precautions. At the same time, the Centers for Disease Control and Prevention recently released new masking and COVID mitigation guidelines and states have started to end masking mandates.

Facing the mental health crisis

As the U.S. starts to return to a sense of normalcy, it is critical to note how woefully unprepared the healthcare system was to handle the surge of a mental health crisis in this nation. Learning the lessons from how the past two years have taxed the mental health system will be beneficial for the future.

The American Psychological Association in 2021 surveyed psychologists who reported a surge in demand for anxiety and depression treatment, and longer waitlists due to receiving more referrals since the beginning of the pandemic. Psychologists also reported working more hours compared to previous years.

The increase in demand for services is not surprising given the rise in mental health diagnoses and symptoms. In their recent survey of Americans, the CDC found 31.5 percent of Americans reported a symptom of anxiety or depression. The 2022 edition of The State of Mental Health in America survey found 19.86 percent of Americans experienced mental illness.

Unmet mental health treatment needs predate the pandemic and were magnified as the world grappled with the collective trauma of COVID-19.

Source: Rob Hyrons/Shutterstock

As a rehabilitation psychologist who works with medically and socially complex patients at an urban hospital, I have seen an exponential increase in people seeking mental health treatment. I recently treated a patient who was admitted to the hospital for suicidal ideation.

He came to the hospital because he did not know where else to go. Although his symptoms improved while hospitalized, he needed intensive outpatient therapy upon discharge. Disappointingly, these programs had a months-long waitlist and it was impossible to find him a mental health professional who could provide him with care in the meantime.

Certainly, I do my utmost for all my patients, but I have felt overwhelmed trying my best to squeeze in as many patients as I can through constantly rearranging my schedule, working outside of normal hours, and foregoing breaks. When I hear others discuss “returning to normal,” I cannot imagine months-long waitlists, desperate patients, and feeling chronically stressed about work as my new “normal.”

The increasing demand for mental health providers

Prior to the pandemic, the APA projected that the demand for psychologists would increase by 6-27 percent by 2030. Increasing the number of mental health providers to meet this demand is a logical solution.

Recently, the University of Nebraska Medical Center intentionally set up programming to encourage medical students to enter the field of psychiatry. Medical schools, colleges, and universities can work to set up similar programs and promote graduate school programs in clinical and counseling psychology and social work.

Often, these programs are housed in large universities with a large undergraduate population. Educating students about career paths in mental health, creating mentorship programs where they shadow a mental health provider, and establishing financial incentives to enter the field of mental health through loan forgiveness could help with developing the workforce.

Telehealth services

Expanding telehealth services in areas that are underserved is vital to improving access to mental health care. Mental health providers are unequally distributed across the US. Treatment via phone and video can move to reduce this inequity.

Treatment outcomes are equitable between in-person and telehealth therapies. There is also greater adherence to telehealth follow-up visits versus in-person appointments. PSYPACT is an interstate compact that allows psychologists to see patients who live in member states across state lines. Patients who would not have access to care due to their location or long waitlists in their area would have access to many more providers and clinics.

Brief interventions in primary care settings

Primary care settings are often the first place patients discuss mental health concerns. Training staff in these clinics to screen for and ask about mood and emotional changes and to provide brief interventions is important. Early assessment and normalizing mental health as an integral part of overall health can help with prevention, symptoms severity, and reducing mental health stigma.

Training primary care providers in brief intervention techniques such as motivational interviewing can effectively help patients attempting to make behavioral changes such as cutting down on alcohol and or drug use or making changes to promote adaptive coping.

Additionally, including mental health providers on these teams would allow for collaboration amongst staff, and will provide urgently needed treatment to patients who may not have been reached otherwise. Integrated care has been found to reduce depression.

Economic concerns

To be sure, it takes time and economic resources to recruit and train new mental health professionals and change existing telehealth laws. Resources are needed to educate and train health professionals to assess for emotional disturbance and other mental health concerns.

This can be measured against the reality that anxiety and depression cost the global economy an estimated $1 trillion. The U.S. loses $300 billion annually due to lost productivity from mental illness. People diagnosed with mental health disorders are also at increased risk for chronic health issues, putting them at increased risk of medical complications.

The past two years have been mentally and emotionally exhausting for millions across the globe, across industries, and across borders. It is understandable that many are itching to return to life as it was before the COVID-19 pandemic.

Expanding access to care through increasing telehealth services, growing the number of mental health providers, and investing in integrated primary care can assist with the return to normalcy for many Americans.