Mental Health Telehealth Services During COVID-19 Pandemic
Preamble
As a result of the COVID-19 pandemic, telehealth services have become a staple of mental health service delivery and are expected to continue even after the end of the pandemic. Mental Health Association in New Jersey (MHANJ) is dedicated to ensuring that individuals experiencing mental health conditions receive access to telehealth services for the treatment of their conditions.
Through conducting a randomized research study, MHANJ found that the majority of current ICMS clients utilizing telehealth services most commonly engage in voice-only services- a finding that necessitates this form of virtual treatment be both accessible to consumers and covered by health insurance providers. Therefore, MHANJ recently supported and offered recommendations to bill S2559/A4179, which if passed, would require healthcare private insurers and Medicaid plans to include coverage of voice-only telehealth services. S2559/A4179 has unanimously passed in both the Senate and the Assembly. MHANJ will remain dedicated to endorsing future bills that will provide greater access to telehealth services to people in need, during and following the COVID-19 pandemic.
This article details the study conducted by MHANJ, which highlights the importance of voice-only telehealth services for mental health conditions by examining the telehealth practices and preferences of individuals receiving mental health case management services in New Jersey.
Impact of COVID-19 on Behavioral Health Services
The onset of the COVID-19 pandemic presented significant threats for people living with mental health conditions to access the in-person mental health services on which they depend. In the early days of the pandemic, it became clear that the overwhelming practical and emotional consequences of this unprecedented event necessitated the establishment of virtual services to ensure the continuity of mental health treatments. MHANJ identified the importance of telehealth services for persons isolated by the pandemic, and subsequently determined that receiving objective feedback on telehealth from persons with lived experience in mental health was critical, as telehealth services are now expected to last even after the close of the pandemic.
In July/August 2020, MHANJ conducted a purposeful pilot study with 75 consumers of mental health telehealth services. The results were compelling, however the need still existed to poll a population more representative of the public system of mental health care in New Jersey.
Understanding Experiences of Telehealth Utilizers
MHANJ conducted a randomized study of New Jersey’s ICMS (Integrated Case Management Services) population. This study was designed, approved, and implemented in 4Q20/1Q21. Through a 12-question electronic survey distributed by case managers, a total of 878 ICMS clients comprised the sample size of the study. The objective of MHANJ’s study was to gather information about consumers’ experiences and perceptions relating to telehealth services for mental health conditions. Ultimately, the study aimed to demonstrate the current impacts of telehealth and provide a basis for the future of telehealth services.
Benefits of Telehealth/Findings from Utilizers of Services
The study ultimately found that telehealth services are very positively regarded by ICMS clients throughout the state of New Jersey. The majority of participants felt that telehealth has been a safe way to seek care during the pandemic (95%) and is a great alternative to in-person care when face-to-face services remain largely unavailable (81%). Respondents also agreed that teletherapy is effective in treating their conditions (78%), is very convenient (90%), and has allowed them to feel connected to others while social interactions may be limited due pandemic-related restrictions (83%). The study also discovered that nearly all respondents use voice/phone calls to participate in telehealth sessions (97%), resulting in the very significant finding that voice-only services are the form of telehealth most often used by ICMS clients.
The majority of respondents also agreed that telehealth:
— Saves them time (84%) and money (77%) on transportation.
— Is helpful because they do not need to arrange transportation (82%) or childcare (51%).
— Is flexible with their work schedule (62%).
While transportation, money, and access to technology are often accepted as common barriers to accessing mental healthcare, the findings of this study show that telehealth services overcome such obstacles. Since the majority of participants agreed that telehealth allows them to spend less time and money to access appointments, these responses indicate that telehealth offers a higher level of convenience than in-person services.
Preference of In-Person Services vs. Telehealth Services
While almost all participants agreed with the benefits of telehealth (ex. saving time, money), 41% of respondents indicated that they actually prefer virtual services over in-person services. There is likely a wide variety of factors that may explain consumers’ preference of in-person services over telehealth; further research may be needed to determine and evaluate these potential factors. This compelling finding indicates that while telehealth services continue as the standard for behavioral healthcare amidst the pandemic, the desire for in-person services in addition to telehealth services persists within the ICMS population. In a prior pilot study on telehealth (July 2020), providers and consumers of services agreed that telehealth services should be utilized when both parties agree it would be beneficial.
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Advocating for Telehealth Services
This study ultimately showed that telehealth services for mental health have offered a convenient and safe way for individuals receiving ICMS services to utilize telehealth. The study’s compelling finding that the majority of respondents utilize voice-only services more frequently than any other form of telehealth reinforces the need for this method of treatment to be both accessible to consumers and covered by health insurance providers.
Important Message from the President: Parity Legislation Signed Into Law
Governor Murphy signed the Parity Bill into law in April 2019! It has been a long road and we are proud to say that the Mental Health Association in New Jersey has been a strong member of the Parity Coalition. Barbara Johnston, our Director of Policy and Advocacy, has worked to define and develop parity in healthcare coverage over the past several years. With our partners, the National Council on Alcoholism and Drug Dependence, and others, we have been a strong voice for accountability and transparency between insurance coverages for physical and behavioral health treatment. This new law will hold managed care organizations (MCOs) accountable for reporting inequities to the Department of Banking and Insurance. The department will report their findings to the legislature on a yearly basis. We will finally have data that identifies differences in restrictions such as prior authorization, step therapy, and network adequacy. Thank you all for your support and activity on this issue. It’s one more step toward equality for those with behavioral health issues.
— Message from Carolyn Beauchamp, MHANJ President and CEO
Left to right: Commissioner Carole Johnson, Department of Human Services (DHS); Valerie Furlong, Denied Treatment Group; Senator Tom Kean; John Jacobi, Seton Hall University; Ed Martone, National Council on Alcohol and Drug Dependence (NCADD); Governor Phil Murphy (seated); Assembly Speaker Craig Coughlin; Phil Lubitz, National Alliance on Mental Illness (NAMI) New Jersey; Commissioner Marlene Caride, Department of Banking and Insurance (DOBI); Barbara Johnston, Mental Health Association in NJ (MHANJ); and Mary Abrams, NJ Association of Mental Health and Addiction Agencies (NJAMHAA)
How We Do What We Do
The MHANJ Government Affairs (GA) Team works to ensure that New Jersey residents have access to quality behavioral health care (mental health and substance use). We advocate for integrated behavioral and physical health care. We are proactive in supporting parity for behavioral health with physical health care. The GA team manages MHANJ’s advocacy, legislative and public policy work on the state and national level. This is accomplished through working with legislators and key governmental leadership officials; assuring a strong peer/consumer voice while supporting choice and the rights of individuals. The GA team operates under the core belief that wellness and recovery is attainable.
Listed below are policy positions on mental health-related issues that have been accepted by the MHANJ Board of Directors. For the MHANJ’s stance on issues that are not listed below, please contact Barbara Johnston, Director, Policy & Advocacy at bjohnston@mhanj.org.
Insurance Questions about Mental Health or Substance Use Treatment? We Can Help!
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Our Insurance Specialists can help you navigate the insurance landscape and answer questions about private insurance, Medicaid and Medicare coverage. If you are underinsured or have no insurance, we can connect you with state-funded treatment programs through the New Jersey Department of Health, Division of Mental Health and Addiction Services.
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