PSYCHIATRIST STAFFING

As previously discussed, taking care of our mental health is important because it’s a vital part of our life which can impact our thoughts, emotions, and behaviors.

Being “mentally healthy” is a positive. It can make us more productive and effective in everyday activities such as work, school, parenting, etc.

It might seem like when the COVID-19 pandemic outbreak first occurred, a lot of people started reporting and seeking mental health services. However, did you know that prior to the pandemic, 19% of adults were already experiencing a mental illness?

America has been facing a mental health crisis since long before COVID-19 and things aren’t getting any better.

So how exactly did the worldwide pandemic affect the ongoing mental health crisis?

The COVID-19 pandemic had a disastrous effect on the mental health of the entire nation. We can all agree that the risk of contracting the virus alone caused a traumatizing event for everyone.

But in addition, COVID-19 led to change in our physical and social environments which led to greater rates of isolation, loneliness, financial hardship, housing and food insecurity and interpersonal violence – all affecting the mental health crisis of the nation.

To be more specific, let’s look at Mental Health America’s (MHA) 2021 State of Mental Health in America report to understand how society was affected:

• Suicidal ideation among adults increased by .15% (or over 460,000) people from last year.
• 24% of adults with a mental illness reported an unmet need for treatment (this number has not declined since 2011).
• 7% of youth in the U.S. have severe major depression; this rate was highest among youth who identify as more than one race at 12.4%.
• 60% of youth with depression do not receive any mental health treatment; even in states with the greatest access 1 in 3 are going without treatment.
• Even among youth with severe depression who receive some treatment, only 27% receive consistent care.
• 8% of Americans with a mental illness are uninsured; this increased for the first time since the passage of the affordable care act.

In 2014, MHA created an online screening program which includes a collection of ten free, anonymous, confidential and clinically validated screens that are among the most used mental health screening tools in clinical settings.

Overall, through September 2020, over 6M people have taken a screen.

But more specifically, from January to September 2020 (during the peak of COVID-19), approximately 1.5M people have taken a screen. From these 1.5M people, the data collected tells us that:

The pandemic not only affected society in general, but it disrupted the entire U.S. healthcare system.

Here are some key highlights from a Psychiatry Research study to understand how COVID-19 affected psychiatric care:

• In outpatient settings, the biggest changes occurred thanks to telehealth. When the pandemic outbreak first occurred, the U.S. government temporarily waived numerous regulations as well as regulatory barriers to allow for various platforms to be used nationwide.
• In inpatient settings, no visitor policies and suspension of group activities were implemented in select facilities as well as the tightening of admission criteria.
• When it came to consultation services, hybrid models were implemented to leverage all available resources. Plus, triaging, and determining whether patients were going to be seen in-person, via phone or video.
• Overall, clinicians experienced stress, anxiety, and fear plus they were affected financially and ethically. They also had specific concerns when it came to COVID-19.

Even though COVID-19 disrupted mental health services in 93% of countries worldwide, the pandemic has also allowed for psychiatric care to evolve.

Here are some highlights of what psychiatric settings have done to adapt and continue evolving:

• Outpatient psychiatric care now includes several virtual modalities (telehealth, telepsychiatry, work from home/virtual trainings etc.)
• Patients referred for inpatient psychiatric admission are immediately given a rapid COVID-19 test prior to being evaluated by a psychiatrist and being admitted to an appropriate unit.
• In emergency room cases, patients are given the choice to consult with a physician via telephone (if they don’t need to be seen in person). If they do, all personnel including patients are following social distancing guidelines plus the use of masks.
• To help mitigate the risk of infection among healthcare staff, some healthcare systems have transitioned to a shift work model.
• Leadership at many inpatient psychiatry settings are making the necessary changes to keep patients and staff safe by working together, communicating, and producing the best solutions. Some changes that occurred included:
  • Screening, re-screening, PPE, use of designated clothing, cleaning of surfaces, disinfection etc. were implemented to prevent the spread of COVID-19.
  • Medical student(s) visits were minimized.
  • Back-up pools and job reassignments for physicians were created (as needed).
  • Isolation rooms in psychiatric inpatient units were created.
  • The number of visitors were restricted.
  • The criteria for psychiatric admission were tightened.
  • Changes to group therapy sessions (i.e., limiting the number of participants, utilizing social distancing) were implemented.

• Psychiatric care on the consultation-liaison service started using virtual methods to provide care. But, in some cases, hospitals continued to see patients in the emergency room and obstetrics floor depending on the severity of the case, with the appropriate use of PPE.
• Select state-supported community behavioral health organizations and programs of assertive community treatment developed COVID-19 response protocols for various settings such as shelters, mental health group home residences, clinics, home visits, etc.
• Several states implemented policy, regulatory and payment reforms for the provision of remote telehealth, access to residential care staff and medications, and financial support for community-based services.
• Psychiatric residencies were and to date are producing creative ways to train residents.

As the pandemic continues, and the demand for mental health services increases, we must remain positive to produce solutions that address these issues while allowing us to evolve.

COVID-19 is always going to create a positive and negative impact.

However, as a nation, we must continue to face those challenges to innovate and evolve.

The evolution of psychiatric care is the perfect example of how, we came together to find solutions and revolutionize healthcare.

Because of this, new trends in the mental and behavioral health space emerged.

Here are 7 mental and behavioral health trends to look at:

1. Increase Demand for Behavioral Health Services – Demand for behavioral health services jumped tremendously in 2020 due to the COVID-19 pandemic. Even though its well over a year in a half since the coronavirus outbreak, millions of Americans are still struggling with unemployment, depression, uncertainty etc. and so mental and behavioral health services are expected to continue rising past 2021.
2. Employee Mental Health/Wellbeing Becoming A Budget Line Item – As we just mentioned, millions of Americans are still facing mental and behavioral health challenges, which can impact job performance, productivity and retention. With that in mind, organizations have recognized the importance of investing in mental health and wellness benefits (i.e., counseling, yoga, flexible scheduling etc.) for their employees as this can have a positive impact on productivity, retention, workplace satisfaction, job performance, employee engagement and more.
3.  Telehealth and Telepsychiatry – Thanks to COVID-19, telehealth and telepsychiatry emerged and is still being used today to deliver mental and behavioral health services. Telepsychiatry allows for individuals across all populations and socioeconomic status to have access to cost-effective mental health care, creating a sense of safety, security, and privacy for many patients.
4. Measuring Patient Outcomes – Access to mental and behavioral health has increased – and, while providers are focused on providing care to patients, they need to know how to measure the impact of the care they are delivering. Billions of funds have been poured into the behavioral health industry; therefore, healthcare leaders should educate providers on how to measure care outcomes, define measurement-based care etc.
5. Behavioral M&A Activity – As the demand for behavioral health services continues to rise, the more investor attention is it expected to gain – especially since volumes and financial performance of numerous elective and procedure-based provider sectors haven’t returned to pre-COVID-19 levels.
6. Increase in Federal Funding – Trillions of dollars have been allocated to the behavioral health industry since the start of the pandemic to help address the nation’s mental health. With these funds available to mental health organizations, their role is to provide sound mental health care; otherwise, organizations lacking good quality clinical care will fade.
7. Financial Failures – Even with the billions of dollars that have been allocated to the behavioral health industry, there are still some providers that will be forced to close doors. Financial failures will most likely continue this year as providers continue to deal with decreased revenues, increased costs, overworked staff among other challenges.