The urgent need to treat patients safely during the pandemic led to a telehealth boom. Telehealth opened the door to new treatment pathways for all of medicine, none more so than for therapy. While the promise of teletherapy to expand access to care is significant, the reality is it does not serve the needs of all those seeking treatment – and in fact, for many, it continues to keep behavioral health care out of reach.
Consider a factory worker who clocks in at dawn and cannot slip away for a midday therapy session. Many shift-based workers juggle multiple jobs, fatigue, and limited downtime. Telling them to fit teletherapy into a break assumes not only steady internet access but also technology that can handle a video call. Telehealth also doesn’t solve the access issues for individuals who can’t afford out-of-pocket costs or find a provider accepting their insurance. We have convinced ourselves that teletherapy alone can solve the access issues in the US. Unfortunately, virtual therapy and telehealth visits still mirror the same barriers found with traditional therapy.
When we limit digital mental health to virtual appointments, we diminish their real value and overlook an important reality: the real value of digital mental health treatments is where opportunity meets need. There is a huge gap in care in the US, particularly with behavioral health. The workforce shortage among mental health professionals persists, so the same barriers remain, and the gap is growing exponentially every year. The only way we can address this gap adequately is to adopt other treatment modalities to get those suffering the help they need. At-home treatments or digital mental health treatments are often the best solution to addressing this rapidly growing problem. These types of treatments provide the opportunity for the individual to choose the best path that suits their needs and empowers them to take control of their own health. We must change the mindset of mental health care from one where the only option is the standard of care, to a position where we help people get access to any validated treatment that allows them to access care on their terms.
States like New Mexico have taken an interest in these approaches, extending Medicaid coverage to device-based therapies for people who cannot easily travel or who lack high-speed data plans. The Department of Veterans Affairs and certain regional health plans have also expanded coverage. Their initiatives are backed by new CMS-approved codes that acknowledge the need for a more robust approach to mental health, and now incorporate these novel mental health treatments as part of the treatment paradigm. This is a clear acknowledgment that not all solutions revolve around a 45-minute call or in-person therapy session. These codes enable providers to adopt these treatments into their patient care plans and pave the way for payers to reimburse a broader range of treatments. Ultimately, this will reach those individuals who keep America running but don’t have an easy on-ramp to care.
When we position teletherapy as the primary platform representing digital mental health treatments we conflate a single mode of care with the entire spectrum of digital mental health options. If the goal is to narrow the mental health gap, we need to empower people by providing them with all available options and ensuring a positive patient experience. More importantly, these treatments not only improve consumer choice, but they provide an opportunity to improve care by reducing stress on clinicians, who can now triage patients based on the severity of their symptoms and utilize at-home treatments to allow more time for patients requiring intensive care.
It is time we realize that there is no single panacea for mental health; the need to break down barriers for working families and individuals in rural towns or underserved communities requires we move past a narrow definition of telehealth. By embracing innovations reimbursed under the new codes, payers and providers can expand care to those who struggle most with traditional therapy. We are at a watershed moment in mental health care that calls for an honest reappraisal of what digital mental health can achieve and demands the expansion of reimbursement for those treatments not currently covered under the new CMS codes.
Joseph Perekupka is the CEO of Freespira, the only company to offer a medication-free, FDA-cleared digital therapeutic treatment proven to reduce or eliminate symptoms of panic disorder, panic attacks and PTSD in 28 days. Joe is a proven healthcare leader with over 25 years of commercial experience in multiple leadership and functional medical device and digital health roles. He plays an active role with organizations such as the Digital Therapeutics Alliance and DTx societies, where he maintains co-chair roles that are focused on propelling the DTx industry growth, and is passionate about creating equitable access to care for mental health patients nationwide.
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