Advancing Technologies in Behavioral Health Care: A Policy Briefing and Advocacy Agenda
Behavioral health disorders are a major source of disability and distress. An estimated 26 percent of Americans ages 18 and older —- about one in four adults —- suffer from a diagnosable disorder in any given year, and 46 percent will have a mental disorder over the course of their lifetime.1 Many individuals experiencing mental health and/or substance use disorders often experience comorbid behavioral and physical illnesses, disability, reduced life expectancy, and premature mortality.
Despite the high prevalence of behavioral health disorders, growing acknowledgement of the pain and human suffering they cause, and increasing evidence of the economic burden worldwide, the majority of adults and children with behavioral health needs who could benefit from care go without it. Systemic as well as attitudinal barriers to seeking and receiving behavioral health care have been well-documented in the literature, including: cost, convenience, confidentiality concerns, lack of availability, and fear of stigmatization and discrimination.2 Help for these individuals has also been limited by the need for more effective evidence-based treatments, the shortage of behavioral health professionals trained in evidence-based therapies, and the lagging adoption of technology-based solutions to deliver new treatments, enhance access to care and improve behavioral health outcomes.
Technology-based interventions have the potential to significantly improve the efficient assessment and treatment of behavioral health disorders. They offer an unprecedented opportunity to address the human tragedy and public health crises resulting from under-recognized and under-treated substance use and mental health disorders. To date, however, the pathways to wide-spread adoption of these technologies have been filled with numerous barriers and challenges. In response, Vibrant Emotional Health’s Policy Briefing and Advocacy Agenda to Advance Behavioral Health Technology will highlight technology-based tools and the ways they can improve behavioral health interventions and outcomes in order to:
- Improve access to mental health and substance use disorder care for people who would otherwise not see a behavioral health clinician.
- Mitigate health care and disability costs for behavioral health conditions.
- Promote early-identification, assessment, and less-costly treatments of mental and substance use problems.
- Empower individuals in self-management of overall physical and emotional wellness, disease prevention, and disease management.
- Improve behavioral health outcomes and quality of care for all individuals in need
- Reduce morbidity and mortality of people with co-occurring disorders.
- Increase general physical and emotional wellbeing and promote healthy life-styles.
- Connect people to behavioral health care where, when, and in the manner in which they wish to receive it.
This policy brief: 1) provides highlights of technology-based tools that can improve the care of people with mental health and substance use conditions; 2) identifies current barriers, concerns, and ethical considerations that must be addressed in order to advance the use of these tools; and 3) concludes with recommendations to support the safe and responsible dissemination of evidence-based technology innovations in behavioral health care.
- Early identification, assessment, and treatment are three keys to turning the tide on the increasing economic and human burden caused by untreated mental illnesses and substance use disorders.
- For many who would never see a clinician because it is too expensive, inconvenient, or is just not available, mobile, wireless, and telecommunication technologies offer new ways to assess, monitor, and treat behavioral health conditions anywhere, anytime, in the moment.
- We believe that the digital future of our field is rapidly advancing, and by working together we can harness the full potential of technology for improving behavioral health and achieving emotional wellness.
- Key barriers. Technology-enabled tools and approaches to care have the potential to bring behavioral health care to millions of people who presently are without access. Most of the tools currently on the market; however, lack scientific evidence to support their claims of clinical efficacy. This barrier must be addressed first and foremost. Other significant barriers identified in the Policy Paper include protections for personal and confidential information; limitations of billing/reimbursement models by public and private payers; cumbersome and inconsistent professional licensure requirements; ethical concerns and liability; and inadequate infrastructure in behavioral health settings to collect, manage, and share health care information in compliance with Federal laws.
- Key recommendations. Vibrant Emotional Health offers numerous recommendations to achieve wider adoption of technology-based interventions, starting with significantly increased financial support by the National Institutes of Health and other funding bodies to accelerate research opportunities by credible public and private institutions, including the FDA. Additional key recommendations include greater privacy protections of user health data; financing and reimbursement reforms by government and private payers; streamlined licensing standards for clinicians across-states; and support for electronic record infrastructure enhancements in behavioral health settings.