“This is the only safe place I have in my life right now.”
We heard loud and clear from our community member, Margaret, in April as COVID-19 restrictions were put in place in North Carolina, where Margaret has been in treatment for alcoholism. As we moved the majority of our community members to virtual care and accepted patients whose treatment providers could not transition to virtual, several providers made the decision to keep care sites open for patients who wanted to continue seeking treatment in person.
As the world reacts to COVID-19 and moves to virtual, particularly in healthcare, there has been rapid adoption of telehealth and those touting its benefits.
From convenience to expanding access, the option of telehealth and virtual care is a net positive for our health in this country. But for many, it’s not viable or optimal, particularly as the only option long-term. Specifically, in mental health and addiction treatment, where trusted relationships and longitudinal care are critical to positive outcomes, patients require personalized care plans and access to multiple modalities.
The majority of our community members have transitioned successfully to virtual care, and they love the convenience and flexibility. But others have not been able to move to virtual or prefer coming to us in person.
For some, access to or comfort with technology and broadband is a major barrier, and often these are individuals who have been marginalized and underserved. According to a survey done by the Pew Trust, of those Americans who own a cellphone, 15% are not smartphones, and those without access to a smartphone and/or adequate broadband are more likely to be older, lower income, less educated, more rural and non-white.
The shift to virtual care as the preferred or only modality carries the risk of leaving these already underserved populations behind.
Reports of the successes of adoption of virtual care have led to the emergence of more and more providers of telehealth solutions. In fact, according to Rock Health, behavioral health tech raised $588 million in the first half of 2020.
Specifically in substance use disorder and addiction treatment, an in-person visit was previously required by federal regulation to prescribe much needed medications, but this requirement has been suspended to enable this important treatment delivery without the risks of spreading COVID-19.
Subsequently, there has been a proliferation of virtual prescribers of medication, but most not providing the therapy and other wrap services critical to long-term success in recovery.
While in many ways, this expanded access is positive, there’s a risk that investments in virtual-only models will create a shortage of solutions that work for all.
Like many other industries, healthcare and addiction treatment need to evolve to be more personalized, multi-modal/omnichannel, and comprehensive. Comprehensive and omnichannel models have a greater opportunity to build trusted relationships, which in turn address needs that only surface when whole person care is the goal.
As healthcare moves in this direction with its focus on social determinants of health, so too should mental health and addiction treatment.
Corbin Petro is the CEO and co-founder of Eleanor Health.