Mental Health in America in 2022
The U.S. is facing many issues when it comes to population mental and behavioral health. Data show that 1 in 5 adults lives with a mental illness, nearly 2.5 million youth report living with depression, and substance use has become a strenuous social determinant of poor mental health. What’s more, an increasing number of those needing mental health services are not able to access effective, culturally appropriate care. Promoting population mental well-being and encouraging access to mental health support should be a public health priority, including the reduction of barriers to care. Telemental health—the use of videoconferencing technology to provide mental health services—is a promising way to improve population mental health through the provision of timely, accessible, culturally sensitive behavioral health care.
The COVID-19 pandemic has exacerbated poor mental health throughout the United States. Youth, adults, and seniors in many communities report feelings of stress, loneliness, anxiety, depression, and substance use has also increased. Today, the mental health support system is difficult to understand, navigate, and access. Individuals are expected to know what types of support they need, where, and when to access them, without prior mental health literacy training. Lawmakers, public health professionals, and policy experts are grappling with the need to develop and implement policies that promote mental health and provide wide-ranging access to mental health support services.
Identifying Upstream Causes and Helpful Solutions
Larger issues have also contributed to an increase in collective angst in the U.S. Many communities have little to no access to a social safety net—health insurance, child care, affordable housing, or universal basic income—and are additionally plagued by the effects of social injustice, systemic racism, police brutality, and historical and current trauma. The many individuals and communities facing those issues need access to mental health resources.
Telemental health support services are an important tool, providing immediate assistance to individuals and communities. The CDC has identified telehealth as a helpful tool in closing the gap between mental health needs and access to services, and the American Psychological Association identifies telehealth as an important tool for population health and mental health promotion.
During the COVID-19 pandemic, online support provision and service delivery has proliferated and such services are revolutionizing mental health care. Telehealth services have been demonstrated to reduce the risk of transmission of communicable diseases in high-risk areas where physical presence is not required for the provision of medical and psychological care. They also address the need to scale by increasing provider capacity to provide care to communities previously underserved due to an isolated or rural location. This increased capacity and online infrastructure can be leveraged and expanded to provide a wider array of clinical and non-clinical mental health services to the communities in an accessible, equitable way. Examples of this include, but are not limited to, peer-to-peer support services, or professional-mediated support communities.
What is Telemental Health Support?
Telemental health encompasses methods of mental health support delivery offered remotely via chat, email, videoconference, and/or phone conversations. Individuals, organizations, and mental health professionals are able to use internet-facilitated technology to provide a wide array of therapeutic services, as well as non-clinical support. Emphasis is placed on increasing individual autonomy and decision-making, reducing stigma, and promoting the adoption of beliefs, attitudes, and tools leading to the improvement of one’s state of mental health.
Telemental health offers the ability to access clinical and non-clinical services ranging from access to mental health promotion leisure activities to peer-to-peer and substance use support group gatherings. Community members are able to receive care and participate in activities of belonging in a comfortable setting, often from their own homes. People are able to receive care without the logistical challenges or cost of traveling. This provides an opportunity for health promotion and therapeutic services to expand in rural areas, as well as lower-income communities.
Expanding Equitable Access and Culturally-Appropriate Care
Many will benefit from the increased availability of mental health support services online, including support seekers and providers. It will also help support individuals working and learning from home, children, and youth, all reporting higher levels of stress and mental disorders. Online and remote mental health support infrastructure helps in enhancing equitable access for many. Rural, minority, low-income, and linguistic minority communities would gain access to many services previously inaccessible within a system ill-equipped to address their needs. For example, The Lifeline and 988, both suicide prevention and mental health support services, are currently available in multiple states. The service is expanding and will be available nationally in July 2022, increasing equity of access to this mental health resource.
In the era of the COVID-19 pandemic, industries and businesses have changed their practices to expand work from home capacity and remote service delivery. It has allowed many to continue earning a living while reducing the risks associated with gathering in the workplace. While beneficial for many, working from home can lead workers to feel isolated, and disconnected from their social network and a support system. There is a gap to be filled in providing mental health communities online, countering the isolation felt by some who are working with different physical restraints.
Children and Telemental Health Support
Children and youth are living with higher rates of anxiety, depression, substance use, and other mental health concerns, and this predates the COVID-19 pandemic. Data provided by the US Surgeon General report that 1 in 5 children ages 3 to 17 lived with a mental, emotional, developmental, or behavioral disorder before the start of the pandemic. Home and school environments, access to community support, and the use of technology and social media play a significant role in shaping youth mental health. There is a need for policy and services targeted at addressing youth mental health concerns, which have only intensified since the onset of the pandemic.
Telemental health services present a great opportunity to improve access to services, especially as children and youth are requesting access to mental health services online or remotely at an increasing rate. Online and remote mental health support infrastructure needs to catch up and be offered to children and youth, especially as they are spending more time in online spaces. Currently, there is an inequitable distribution of telemental health support available for youth—those living in lower-income communities have access to fewer therapeutic options, and less financial and logistical support from parents and caregivers.
Future Opportunities
Telemental health services address equity concerns in access to mental health support, like having to travel long distances to receive care, which is a significant barrier. With increased telemental health, more people would have the option of choosing culturally-appropriate care, in the language of their choice, and at a lower cost. Access to broadband and new technologies is growing in America (although still inequitable), and increasing broadband access could catalyze increased access to telemental health. More should be done to increase mental health promotion and literacy. individuals need to know where they can turn to for support.