Enlisting Technology to Address the Looming Behavioral Health Crisis

In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates.

Before coronavirus, our country was experiencing its own silent mental health epidemic. One in five adults experience some form of mental illness each year and, as new data highlights, pediatric mental health visits to the ED increased 60% between 2007-2016. With this year’s Mental Health Awareness Month coinciding with a global pandemic and the highest unemployment rate since The Great Depression, I can’t help but share the concern of experts and agencies anticipating an unprecedented mental health crisis. 

So many of us are experiencing isolation and loneliness, job loss, and anxiety from social and economic upheaval. For those already living with mental health issues, however, the compounding effects of this crisis can be devastating. My heart goes out to those who have experienced loss during this pandemic but have been unable to say their goodbyes or find comfort in traditional rites of mourning. I worry about frontline healthcare workers, many of whom are experiencing anxiety, depression, and PTSD — even suicidal thoughts — from exhausting shifts tending to the sick and dying. There is also growing concern that individuals and populations with more acute mental health disorders (e.g., the homeless) are forgoing care due to social distancing orders.

The pandemic is making it clear that we can't neglect or isolate behavioral health but must instead see it as integral to caring for the whole person. Studies have shown time and again how deeply intertwined mental and physical health are. In some cases mental health directly impacts physical health, whether due to chronic stress on the body or engaging in risky behaviors. Behavioral health challenges also make it more difficult for people to adhere to care and treatment plans. Not only is addressing behavioral health crucial to people’s total wellbeing; it’s also essential for containing runaway costs to the system. A McKinsey analysis of national insurance claims data found that 60% of overall medical expenditures are driven by the 23% of members who have mental or substance use disorders.

As a physician and technology leader, I see behavioral health — and its integration into a whole-person approach to care — as an area ripe for innovation. These four strategies to address the U.S.’s rising demand for behavioral health are top of mind for me: 

• Increase access. The digital front door has expanded the access point for patients to get the care they need—and the same holds true for behavioral health. Traditional healthcare providers can leverage technology capabilities such as AI-driven chat bots, virtual assessments and triage, and virtual care appointments to help reduce barriers to entry for patients seeking care and services for mental and behavioral health — a challenge that has long plagued the healthcare system. We can also expect startup digital health companies such as TalkSpace to continue to grow by democratizing access to behavioral health services (they’ve reported a 65% uptick in clients since mid-February). 
• Support and engage patients. Healthcare providers offering behavioral health services can stand up online communities for patients seeking resources, advice, and support from others who may be experiencing similar issues. Organizations can also proactively engage behavioral health patients on digital journeys to ensure they are routing patients to the support they need, when they need it.
• Facilitate better care coordination between care teams. Care coordination is vital, especially in transitioning patients from physical to behavioral health services. Organizations can use a connected platform to drive visibility and collaboration across care teams to ensure that no patient slips through the cracks.
• Strengthen preventative measures for vulnerable populations. Social Determinants of Health (SDoH) factors, such as limited access to food, safe housing, and job security, can lead to prolonged stress and trauma in vulnerable populations. Organizations can bolster their community prevention efforts by risk-stratifying populations based on SDoH data. This information can be used to prioritize community partnerships that help alleviate these stressors and to conduct outreach that will help connect vulnerable groups to the care and services that they need.

Even as we begin to recover, re-open and emerge from the worst of the pandemic, the realities of this crisis will only begin to settle in — likely exacerbating an already wide gap between the supply and demand for behavioral health services in the U.S. (especially in rural areas). Now, more than ever, we need to enlist the power of technology to help the industry better scale and integrate behavioral health services to reach more people in need.

About Ashwini Zenooz, MD:

Ashwini M. Zenooz, MD is currently the Chief Medical Officer and SVP for Healthcare and Life Sciences at Salesforce. Dr. Zenooz was most recently the Chief Medical Officer at the Department of Veterans Affairs (VA) overseeing the national EHR modernization program. She has also held senior policy development and operational roles including serving as Deputy for VA Health Policy and Services, Legislative Health Policy Fellow with U.S. Senator Richard Blumenthal, Committee Staff on U.S. Senate Committee on Veterans Affairs, and Chief of Imaging Services. Dr. Zenooz received her MD in the Medical Honors Program at the University of Florida. She completed radiology residency at Henry Ford Health System and an Abdominal Imaging fellowship at Massachusetts General Hospital. Dr. Zenooz is board certified in radiology and continues to practice medicine today.