Like most of us, the mental health field had a difficult time in 2020. The pandemic created new, acute challenges for patients and providers while worsening long-standing inequities and imbalances in behavioral healthcare. Although the pandemic year saw some positive developments, such as the widespread adoption of telemedicine thanks to sensible and long-over federal policy changes, the overall picture was one of challenge and setback.
Mental health patients and providers now look ahead to an uncertain future. The worst of the pandemic might be over, but the road to recovery will be long and bumpy. It’s not even clear what “recovery” looks like anymore.
Yet we do already understand many of the challenges the field is likely to face in the rest of 2021 and beyond, from ongoing provider shortages to hurdles to telehealth adoption. Let’s take a look at a few.
1. Persistent Provider Shortages
The mental health industry has been hobbled by provider shortages since before most currently practicing professionals earned their degrees. The growth in behavioral healthcare needs has simply outstripped the supply of new providers. In much of the United States, the baseline provider-to-population ratio of 1 to 30,000 is an aspirational goal.
The provider shortage will only get worse without concerted action. Unfortunately, the solutions — to increase the supply of new providers and to make existing providers more efficient — are not as simple as they sound. If they were, we wouldn’t be having this conversation.
2. Limited Access to Behavioral Health Services in Many Communities
The provider shortage factors into an even more fundamental problem: lack of mental healthcare parity. As is the case in so many other aspects of life, where one lives plays an outsize role in one’s access to quality healthcare — including (and especially) mental healthcare. And while behavioral health systems such as Oceans Behavioral Hospital are working to address the problem by adding inpatient and outpatient capacity in underserved communities, more work is needed — and by a wider set of stakeholders — to ensure true parity.
3. A Surge in Behavioral Health Needs Among Young People
Perhaps the biggest mental health challenge to arise (more accurately, to worsen) as a direct result of the pandemic is the surge in young people’s behavioral health needs. Children and adolescents had these needs before the pandemic, of course, but their scale and complexity is far greater in its aftermath.
The mental health industry will have to adjust by adding providers capable of addressing the unique needs of young people (including pre-adolescent children) and by sharpening its understanding of these needs, which have long been seen as subordinate to those of adults.
4. An Uptick in Behavioral Health Needs Among Seniors and Older Adults
The same general factors that contributed to the surge in young adults’ mental health needs during the pandemic, like disruption to school routines and social isolation, are also at play in a less pronounced but still concerning increase in seniors’ mental health needs today. And older adults, of course, have mental health needs not widely present in children, such as those related to age-associated cognitive decline.
5. Uneven Adoption of Telehealth Service
Telemedicine utilization has soared in comparison to the pre-pandemic baseline. Unfortunately, that adoption hasn’t been uniform, and its unevenness may actually exacerbate prior inequities in mental healthcare access. In the coming years, the mental health community and its allies in the policymaking community will need to work to ensure that all Americans have access to quality behavioral telehealth.
6. Inconsistent Insurance Coverage for Would-Be Patients
A detailed analysis by the National Alliance on Mental Illness finds a distressingly large share of would-be mental health patients shut out of the market due to a lack of in-network care options. Whether these patients are actually priced out of care or are merely paralyzed by a market that’s unnecessarily complex, the simple truth is that far too many Americans choose not to seek mental health services because they know (or believe) that they can’t afford them.
The Behavioral Health Field Isn’t Where It Needs to Be
No honest mental health provider would say that the behavioral health field is where it needs to be. As we’ve just seen, the challenges facing patients and providers are acute. Some are actively worsening, threatening any progress made on other fronts.
Some of these challenges predate the pandemic, such as provider shortages. We know what must be done to solve them, even if the work can’t be done overnight.
Other behavioral health challenges were created or made worse by the pandemic, such as a surge in mental and behavioral health complaints in children and adolescents. These issues can be solved, but those solutions might require different tools or different applications of existing tools.
One thing is certain: Inaction is not an option. We owe it to patients and their loved ones to improve mental healthcare for all.