By Betty Rabinowitz, M.D. FACP, Chief Medical Officer, NextGen Healthcare, Inc.
Adults in the U.S. have reported considerably elevated adverse mental health conditions associated with Covid-19, according to a recent study by the CDC based on a survey conducted in June of 2020. Younger adults, racial minorities, essential workers, and unpaid adult caregivers reported disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation. Particularly alarming is the fact that serious suicidal ideation was most commonly reported by people 18–24 years old.
This topic is timely given that September is suicide prevention month and World Mental Health Day is in October. This year, raising awareness to the risks and prevention of suicide takes on additional meaning as the Covid-19 pandemic has clearly had profound impact on so many lives.
Many life stressors have been amplified significantly in the context of the pandemic. Health concerns, employment instability, financial jeopardy, and the stress of caring for children and other family members have all increased significantly. These times have been particularly challenging for patients who were already struggling with depression, anxiety, or addictions before the pandemic.
Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1 percent of the population every year. At any point in time, 3 to 5 percent of people suffer from major depression with a lifetime risk of about 17 percent. Almost 21 million Americans have at least one addiction. Sadly, there is a very strong association between depression, anxiety, and addiction as patients suffering with these conditions often are prone to self-medicate with substances and commonly become addicted to them. About 20 percent of Americans who have depression or an anxiety disorder also have a substance use disorder.
Suicide is caused by a combination of complex factors such as mental illness, substance abuse, painful losses, loneliness, and social isolation. Suicide is the 10th leading cause of death in the U.S., taking the lives of approximately 47,000 Americans each year. Over 50 percent of all people who die by suicide suffer from major depression. If one includes alcoholics who are depressed, this figure rises to over 75 percent.
A more hopeful statistic is that depression is among the most treatable of psychiatric illnesses. Between 80 percent and 90 percent of people with depression respond positively to treatment, and almost all patients get some relief from their symptoms, the same holds true for patients suffering from anxiety.
The Covid-19 pandemic has brought about a major shift in the way patients struggling with depression or other mental disorders are able to access their care. Telehealth has swept across the entire health system, with particular success and acceleration in behavioral health. Behavioral health clinical encounters lend themselves extremely well to telehealth, as they do not require extensive physical examination and they allow a private secure interaction between the provider and patient. In some ways, telemedicine may reduce the stigma of seeking treatment in person for those patients seeking help for the first time.
There is also evidence that outcomes of telepsychiatry equal those of in-person treatment. As far back as 2004, a randomized controlled trial demonstrated this equivalency for treatment of depression. Additionally, in the context of this pandemic, telehealth has demonstrated some advantages, such as decreasing “no shows” by eliminating the transportation and other logistical challenges of in-person appointments for patients.
As some behavioral health providers have been able to increase their capacity by employing telehealth services, their focus has shifted to ensuring their technical infrastructure and workflow support a sustainable capability. In that context, robust telehealth platforms have moved to center stage, enabling effective provider responses to the sudden increased need for services. As depression and anxiety disorders are extremely treatable and so many suicides can be prevented, it is heartening to see technology advances in telehealth translating into better outcomes for this epidemic within the Covid-19 pandemic.
For more information about how NextGen Virtual Visits™ are crucial for survival and success in an evolving Covid-19 healthcare environment, read the ebook “Telehealth in Times of Crisis and Calm.” Learn more about NextGen Healthcare’s telehealth solution here.