Improving access to behavioral health care for Idahoans

Prior to the COVID-19 pandemic, most Idaho behavioral health providers did not readily adopt telemedicine as an option to treat Idahoans.

Developed years ago to provide healthcare to residents of remote areas, telemedicine today offers real-time audio and video-enhanced sessions with behavioral health professionals and medical providers in urban, rural, and suburban settings. The telephone or virtual visits can take place at home, at work or at any other private place with a telephone and internet connection. For behavioral medicine, telemedicine helps improve access. It breaks down traditional barriers to treatment: a lack of behavioral healthcare providers, busy consumer schedules, and persistent stigma surrounding mental disorders.

Research shows that for many behavioral health problems, telemedicine can provide the same outcomes as in-person visits and meet the same standards of care set by the National Committee for Quality Assurance.

Due to Idaho’s geography of 35 rural and nine urban counties, Idahoans often do not have access to behavioral health providers due to where they live and the lack of behavioral health providers statewide.

The federal government, through the Department of Health and Human Services, designates areas of health workforce shortages for communities that lack behavioral health providers. As of 2022, 100% of Idaho has a shortage of mental health providers.

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However, during the COVID-19 pandemic across the country, as behavioral health clients and providers sought shelter and practiced social distancing, stress and isolation exacerbated emotional disorders and demand for phone and virtual care visits soared. In response, Optum Idaho, the Medicaid managed care contractor of the Idaho Behavioral Health Plan, allowed the use of popular apps like Apple FaceTime, Facebook Messenger video chat, Zoom, Google Hangouts video, or Skype. These applications could support its Medicaid members in addition to the approved technology typically required to conduct a virtual session. Optum Idaho also allowed the use of phone visits to address patient needs during the COVID-19 pandemic.

Aided by the ubiquity of smartphones, tablets, and laptops, and people’s increasing comfort with technology, the use of telemedicine for behavioral medicine has greatly expanded during the pandemic and remains a popular mode of care for Idahoans today.

According to data from Optum Idaho, prior to the pandemic, there were an average of 230 unique remote/telehealth service users per month, which grew to 16,460 in April 2020, or a 7,000% increase. Optum Idaho providers continue to average 15,000 unique telemedicine users per month through June 2021.

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At Pathways of Idaho, a behavioral health practice, telemedicine has become almost the only way—and the only safe way—for the 18 therapists to keep their clients cared for. The therapists provided outpatient services in four practices — Boise, Payette, Nampa, and Caldwell — that included individual therapy, family therapy, medication management, and a range of other supports.

To the surprise of providers at Pathways, they found that delivering therapy in the comfort of the patient’s home yielded unexpected breakthroughs. A client scarred by terrible events in her life

as a refugee was able to process and let go of some traumatic experiences from her past – something that she had not been able to do with her traditional office visits. The key? Feel safe in the safety of their home. “Because she felt more comfortable there, things came to light that she didn’t remember before,” explains Susan Martinelli, Pathways clinical director.

The increase in telemedicine use during the pandemic wasn’t just in large urban areas of Idaho.

Therapist Cassie Peck, a licensed clinical social worker who is part of the Optum Idaho network, practices in Sandpoint, a town in Idaho’s mountainous Panhandle region. Her approximately 20 family clients live in the surrounding rural areas and most are Medicaid participants.

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Families are often physically and socially isolated. “I work with families who have very limited support. You may not have family in the area. Or they have a family they are estranged from. Or it’s families who don’t have close friends. They may not have anyone to talk to besides me,” says Peck.

As Peck returns to visit clients in the office, she wants to use telemedicine in case a client is ill or the weather is inclement. “We live in the mountains. We often have snow closures. Some customers live 50 miles from Sandpoint.” She also envisions using it for her families who are moving out of the area but staying in the state.

With the option of telemedicine, Idahoans have excellent access to behavioral healthcare and care can continue uninterrupted.

Click here to read the full case study of Optum Idaho’s commitment to expanding access to mental health care across Idaho through telemedicine and other innovations to break down barriers and increase convenience.

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