Building a Better Behavioral Health Benefit with Telepsychiatry
By: Barry Doan
Original article published on Benefits Pro
The value of an employer’s health benefit strategy is intrinsically linked to its ability to address an employee’s total health—both physical and mental. That’s why overall wellness trends are shifting to better acknowledge the strong connection between a robust behavioral health care benefit and better overall health, ultimately resulting in improved employee productivity.
While many wellness programs today incorporate tactics that promote positive behavioral lifestyle changes, they often fall short of systematically addressing behavioral health conditions that can hinder an employee’s willingness and ability to embrace those needed changes. Altering entrenched behavioral health lifestyle patterns can be difficult, even if it’s a change that would be beneficial for the member. For instance, diabetic employees are much less likely to engage in diet and exercise programs when they are struggling with active depression that robs them of energy, focus and motivation. These members often represent a substantial percentage of those with chronic health conditions who make up a disproportional share of total healthcare expenditures.
This reality is why many companies are setting their sights on comprehensive employee “well-being” as opposed to “wellness” alone. By prioritizing access to both physical and behavioral health care, employers set the stage for more systemic and long-lasting engagement in self-care—and ultimately improve employee well-being, productivity and the bottom line. It’s important to note, however, that while many companies have invested heavily in identifying high-risk, high-cost employees and programs to engage these employees, access to care is still a major obstacle to this change process.
As part of this shift, many employers are incorporating telemedicine options into health benefit packages as a viable solution for addressing access issues related to traditional in-office care. Telepsychiatry is emerging as a growing opportunity within this movement as an effective means of overcoming common barriers to behavioral health utilization such as stigma, busy lifestyles and poor coordination of services. These models help attract busy and reluctant employees who might otherwise procrastinate getting the help they need.
As a clinical model that leverages videoconferencing technology, telepsychiatry and telebehavioral health are used for evaluations, consultations and ongoing treatment. Employees access this care through live, interactive communication with a licensed psychiatry or behavioral health provider in a private setting. This improved access allows employees to not only address their behavioral health concerns before issues become more acute and costly, but also to reduce the behavioral health impairment that interferes with their ability and desire to engage in employer wellness programs.
The behavioral health challenge
The statistics speak for themselves. Behavioral health issues were the leading cause of disability in 2015, accounting for one-third of new claims.
Depression, for instance, ranks high as an employer health challenge, racking up an estimated $210.5 billion per year — nearly half of which is attributed to workplace absenteeism and productivity losses. In fact, one study points to employer costs as high as $3,386 per individual over a two-year period prior to an employee’s depression diagnosis.
Behavioral health issues often impact the effectiveness of wellness programs directed at physical conditions due to existing co-morbidities. One study found that 45 percent of breast cancer patients also had a psychiatric disorder.
While these statistics may be startling, the good news is that companies can achieve notable return on investment in wellness and complex condition management programs by investing in mental health treatment. In one study, researchers found that for every dollar spent treating depression, $1.55 was spent on the effects of depression in the workplace.
It’s not always easy to quantify the impact of behavioral health treatment, but human resource managers overwhelmingly agree that a healthy, well balanced employee is a better teammate and more productive worker. Often, the problem is getting employees to utilize the behavioral health benefits that are already available to them.
Consider a common example: A company launches an active lifestyle program that includes tracking daily physical activity as one means of supporting the employee’s goals of improving her health. A single mom in the workforce, who already struggles with mild depression and anxiety, finds it difficult to rise to the challenge of addressing her wellness goals. Feelings of guilt and inadequacy over this “failure” exacerbate her behavioral health conditions, ultimately decreasing her physical activity and lowering her overall health scores. Unfortunately, the wellness coach does not recognize the behavioral health condition that is impairing participation and fails to make an appropriate referral for additional professional support. The employee becomes demoralized, feels even worse and drops out of the program, and an opportunity is lost.
Even when the employee recognizes the underlying behavioral health condition that is compromising her health and happiness, she may have challenges taking the desired action to address it. While an existing behavioral health benefit would cover the employee’s treatment, she still must do the following research:
- Identify what is wrong and what type of provider she needs to find
- Determine what her benefits cover
- Find which providers can she see that are covered
- Schedule her appointment
- Manage the logistics of attending the appointment which may include taking time off and arranging child care and transportation
Taking hold of the telepsychiatry opportunity
Offering telepsychiatry and other behavioral health care services as part of employee benefits is a trend on the rise, and for good reason
When employees can access psychiatrists and therapists from the comfort of their home or another private space, the behavioral health stigmas are reduced, and individuals are more apt to follow through with care plans. Privacy and confidentiality are also stronger with telepsychiatry because online sessions eliminate the potential of individuals seeing someone they know in a waiting room. Many patients also report greater comfort addressing difficult issues while in familiar surroundings.
Additionally, telepsychiatry expands scheduling options and provider choice, opening the door to greater access. Work and family schedules, for instance, can limit the ability of employees to access traditional services provided in an office setting. Through telepsychiatry, employees can schedule appointments in evenings or on weekends in addition to traditional weekday time slots, which reduces absenteeism or tardiness from work.
The reality is that patient satisfaction trends are higher with online psychotherapy as opposed to traditional face-to-face treatment. While telepsychiatry and telebehavioral health are not for every person, this approach to care addresses many of the common barriers to receiving prompt, professional behavioral health treatment that sets the stage for greater overall health and wellbeing.
Employers seeking to achieve the greatest return on health plan investment are wise to consider telepsychiatry and telebehavioral health as means for promoting use of behavioral health benefits. This effective model of care provides the needed framework for improving access to appropriate healthcare resources and empowering employees to take more control of their health.