Americans don’t have equal access to mental healthcare but technology is making it more democratic
One of the oldest, yet still unresolved issues plaguing the US health system is the unequal distribution of healthcare. This past August, a new study by JAMA revealed the ongoing disparity in healthcare spending by race. In particular, mental healthcare remains highly inaccessible across the board, but particularly for certain groups. Patients are screened for mental health in less than 5% of primary care visits, and Black people are half as likely to be examined than white people. And the elderly are also half as likely to be screened than middle-aged patients.
However, novel health technologies are allowing us to move into a new era of equality and improved access to healthcare for everyone, eliminating the barriers between people and healthcare, by putting the patient at the center of care versus the provider.
Technologies such as virtual care, personal monitoring devices, improved data analytics, and AI-supported clinical decision support tools are already giving patients more direct and seamless access to healthcare.
This demolition of barriers, including physical barriers, is one of the biggest trends in mental and general health for this and the next generation. This is the vital role technology will play in this emerging scenario.
Smoothing access to emergency psychiatric care
The new age of healthtech isn’t just about having Headspace on your phone and telehealth visits with your psychiatrist. It’s also about how life-threatening emergencies can be addressed immediately, without being slowed by a saturated hospital system.
For many years, one of the most pressing emergency healthcare problems has been obtaining necessary evaluation and treatment for patients arriving at hospitals with urgent psychiatric conditions such as suicidal ideation or acute psychosis. Because of the shortage of in-patient psychiatric beds, it would often take two to three days before these patients could be transferred to a psychiatric hospital for definitive care.
But by combining on-demand telehealth calls with other critical services, hospitals can now provide almost immediate emergency psychiatric evaluation and treatment. Instead of waiting days, patients can now be evaluated within hours. And, since almost 70% of these patients don’t require the prolonged in-patient care in a psychiatric hospital, we now free up those in-patient beds for the patients that do. This is technology facilitating “right-size” care, through a more patient-centric vs. system-centric approach.
Virtual care bypasses the roadblocks associated with hospitals and clinics, allowing the patient immediate access to care. This technology isn’t applicable to all illnesses and conditions, but as new monitoring tools emerge that can assess a broader variety of patient symptoms, technology-powered care will improve access to care for an increasing number of urgent health conditions.
While telehealth technology has been around for a number of years, leaders in the field need to be more proactive in bringing all the stakeholders together – from the hospitals to the insurance providers and healthtech companies – and fixing the system issues required to implement the technology.
At-home health tracking can improve and speed up care
Care-in-place monitoring technologies have already changed so many lives – from glucose monitors for diabetes to pregnancy tests. Still, such technologies are only in their infancy. There is a universe of possibilities for cutting-edge personal tools that can not only save users’ lives, but can help our clinicians offer us far more accurate care.
Personal monitoring devices allow for monitoring over a period of time vs. the single point-in-time monitoring of most hospital and clinic tests. Such monitoring, when combined with advanced data analytics including population studies, will significantly advance in our ability to accurately diagnose patients.
Mental health disorders are one of the most underdiagnosed and consequently undertreated conditions. An explosion of new AI and ML-supported technologies are making strides to bridge that gap. For example, self-management apps for mental health involving journaling, and monitoring of voice biomarkers are helping to screen for depression, anxiety, and even alzheimers, in a non-invasive way. These innovative tracking technologies can alert the individual before their condition progresses or worsens. In fact, it was recently revealed that Apple is also working on new technology to detect depression and cognitive decline using iPhone sensor data.
Given that the population is aging, and that approximately 80% of people over the age of 65 years of age have at least one chronic disease, and 80% of patients with chronic disease have some degree of depression, it is immediately evident how better mental health screening will reduce unnecessary suffering. Similarly, anxiety disorder is epidemic amongst today’s youth – it is estimated one in three adolescents now suffers from some degree of anxiety disorder. Early screening for these conditions would aid the many individuals who don’t require high-level medical intervention but would still benefit from care such as counseling, peer intervention, or even an app-based intervention that encourages mindfulness and relaxation.
Connecting health data will make care more accurate and reachable
With the digitization of our health information came the promise of better sharing of health data across care providers. But the path to realizing this promise has been slower than hoped for.
Instead of putting all our eggs in one basket by depending on a single clinician, if all historic patient information were unified, and seamlessly be transferred to any clinician, access to care would open up for all the population.
As we connect data across clinics and hospitals, we’re also generating far more complete and comprehensive health data from our home monitoring tools and wearable devices. That means we can expect to see an exponential increase in knowledge regarding how factors like sleep habits impact our mental well-being, how nutritional intake impacts disease, and much more definitive knowledge on the social factors affecting our health. Forging these connections between patients, providers and health tech will allow for a huge move away from a provider and system centric approach to a patient-centered approach.
We are starting to see the convergence of multiple technologies in health – episodic virtual care, personal monitoring devices, clinician support tools, AI, and information transfer. As more progressive technology and businesses emerge, we’re steadily easing the burden on our overwhelmed healthcare providers and on the patients themselves, while enabling us to reach an unprecedented quality of care and early detection. As a physician, I am incredibly enthusiastic about supporting new innovations, and seeing this generation build a path towards “medicine without walls.”
Photo credit: Olga Strelnikova, Getty Images