Covid-19 is making psychiatric treatment tougher


In the best of times, it can be hard to get mental health treatment. But these definitely aren't the best of times, and even for people who have established relationships with mental health professionals, the coronavirus pandemic is making it harder to find the right care.

The good news is that insurance companies are often reimbursing for telehealth behavioural health services now (even if they weren't before), and regulations on how mental health professionals can practise are relaxing.

And, for most people, telehealth sessions can be helpful, according to Dr Shabana Khan, a member of the American Psychiatric Association's committee on telepsychiatry.

"Telepsychiatry can be used across the lifespan for a wide variety of conditions, including depression and anxiety," Khan said. She said she's also used it to treat more serious conditions, such as chronic schizophrenia.

'It can literally save lives'

For people in crisis, Khan said providers can do initial evaluations through telemedicine, and if a higher level of help is necessary, they can send people for emergency psychiatric care.

For most people, telemedicine for mental health care can be convenient, and right now, "it can literally save lives", by keeping people at home, Khan said.

In general, telemedicine is well received by both patients and clinicians, she said. "Some clinicians are surprised at how much patients are embracing the new technology," Khan added.

Still, the American Psychiatric Association is concerned that not everyone who wants services can get them. Because not everyone has access to a computer or fast internet service, the American Psychiatric Association recently asked the US Centers for Medicare and Medicaid Services to ease requirements and allow telephone appointments.

Vaile Wright is director of clinical research and quality for the American Psychological Association. She said, "It's very normal for people to feel anxious and fearful right now. These feelings can motivate us to protect ourselves and do things like washing hands and physical distancing. It's [a concern] when fear and anxiety lead us to avoid and isolate and panic."

Distraction and loneliness

Of course, it's not easy to tell these days if someone is being prudent when they isolate, or if they're in trouble.

One sign that you should seek help: Your symptoms are interfering in your life or causing you distress, Wright said.

"Don't wait until it gets too bad," she said. "If symptoms start to interfere with your life – maybe you can't get your work done from home or are having trouble attending classes, or if you're neglecting responsibilities or not taking care of yourself or your family, reach out."

That doesn't mean you need to talk to a mental health professional if you have a bad day or two. Almost everyone is struggling now with distraction and loneliness. But, Wright said, if you've had symptoms for two weeks or more, you would probably benefit from talking to a clinician.

Wright suggested contacting your primary care doctor or your insurer for recommendations and to find out who is covered by your insurance.

Important to meet social needs

"Most providers have moved to some sort of telehealth platform," she said. "The rules for this vary from state to state."

Whether you're getting professional mental health care or not, Wright emphasised it's important to try to stay social as much as you can – even with stay-at-home orders in place.

"There are still ways to virtually connect with others, though it will take some creativity and effort," she said. "But, it's important to meet your social needs, even when it might be easier to isolate."

Image credit: Getty Images

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