Mental Health is so important, but we are failing as a country to provide access to the services needed for people who suffer from this challenging set of diseases. This is, by default, a problem best addressed through compassionate caregiving, but technology can help us along the way.
Mental Health Challenges
Mental illness is a growing problem in the United States, particularly among adolescents. However, these disabilities also have outsized impacts on people of color and those with low socioeconomic status. In all, suicide rates have been rising steadily over the last decade, and the US has almost double the rate of its closest competitor in deaths per 100,000 due to mental health disorders and substance abuse. In the United States, there are 43M Americans that have a mental disorder - 18% of the population. However, in 2017, 58% of those with treatable illness did not receive treatment. This shortage is driven by a few key challenges:
Stigma: A stigma surrounds seeking treatment for mental health often causing individual to forgo getting the help they need
Resource Shortage: There is a severe lack of resources available for individuals suffering from mental health conditions, particularly with respect to the availability of physicians. In states like Alabama, there is only 1 clinical psychiatrist for every 1,280 people.
Cost: The cost of behavioral health therapy continues to increase, becoming an insurmountable barrier for many low-income individuals. In most recent research, only 55% of psychiatrists even accept insurance.
The US healthcare system does very little to support individuals with these issues. Medicaid, which has a disproportionately larger share of individuals with mental illnesses than other insurers, provides only minimal support due to financial and policy constraints.
The Right Business Models
Spending on mental health alone currently constitutes $89B per year in the US. Additionally, for individuals with chronic conditions, lack of mental health treatment leads to higher costs of ~$200B per year. 13% of individuals discharged after a mental health admission are readmitted within 30 days of release.
However, as mentioned in the challenges outlined above, we should not seek to control costs in this area of the industry through reduced utilization of services. Instead, services should be deployed in less resource intensive ways to manage ongoing challenges before individuals are admitted to an expensive treatment program. Given this caveat, the following business models could be considered:
Risk Bearing Entity: Organizations that take on the costs of individuals requiring extensive behavioral health therapy that employ better coordination coupled with technology to decrease net costs.
Payers / Integrated Health Systems: Insurers and provider-sponsored plans may pay for access to behavioral health technologies on behalf of members. The costs associated with active care management are frequently much lower than the cost associated with hospital admissions
Out-of-Pocket: Given the relatively inexpensive nature of mobile applications, many digital technologies will be within reach of consumers to purchase outright. Direct to consumer marketing may be applicable in specific instances.
The Right Technology
Digital applications are seeking to harness the convenience and ubiquity of personal devices to address some of the most pressing challenges in the healthcare industry. Behavioral Health has seen rapid growth in the availability of technologies, including, but not limited to:
Telehealth: Providing access to trained mental health professionals from the convenience of the consumer's home
Personalized Treatment and Education: Personalized cognitive behavioral therapy delivered via pre-built learning modules and even Virtual Reality
Symptom Relief: Tools for meditation or sleep induction built directly into mobile applications to help relieve symptoms of anxiety, insomnia, and depression
Ongoing Tracking: Mood and symptom tracking to capture external causes of mental health exacerbations
Social and Family Support: Provide either identified or anonymous access to networks of support through other individuals experiencing similar issues.
Coordination: Treatment of behavioral health issues is reliant on the adequate transfer of information between caregivers.
I am personally ashamed of the way we handle behavioral health as a society. Even if you don’t struggle with this disease yourself, you undoubtedly know someone who does. Let’s come together to provide others with the support they need to overcome these issues and live happy, fulfilled lives free from pain.