MedCity Influencers, Telemedicine

Telehealth’s emergence as the initial gateway into behavioral health services

While in-person visits with mental health providers won’t go away anytime soon, behavioral telehealth is expected to surge, as younger patients seek convenient ways to engage with a provider to address mental health problems.


The escalating shortage of behavioral health providers couldn’t have come at a worse time especially for millennials and their younger Gen Z counterparts.

Rates of major depression rates soared 31 percent among millennials from 2014 to 2017, according to The Health of Millennials report, also noted increases in substance-use disorders among millennials.

But there’s a silver lining to the mental health provider shortage, which could positively impact millennials and future healthcare delivery: More and more patients in the 35-and-under demographic wouldn’t otherwise seek out behavioral healthcare are now using telehealth — or interested in using telehealth — to meet their behavioral health needs.

Forty percent of individuals born between 1981 and 1996 who answered a recent survey said they would regularly use telehealth for behavioral health management — which is higher than any other demographic. Also, millennials are nearly three times as likely to have had a video visit with a doctor compared with other demographics.

If this trend continues, telehealth’s role as a gateway into behavioral health therapy will only deepen – which suggests that there may come a day when the majority of behavioral health encounters are over a virtual connection.

How Younger Patients Are Driving Growth
Consumers in their 20s and 30s accustomed to Uber and Netflix, and believe that the procurement of goods and services — rides to the airport, indie films on demand — should be as easy as owning a smartphone. This desire to have things on their terms, in the precise location and time of their choosing, is shaping the business models of startups.

An Accenture 2019 Digital Health Survey notes, 24 percent of Gen Z individuals (those born after 1997) and 13 percent of millennials are dissatisfied with the convenience or location of care compared with 8 percent of Gen Xers and 4 percent of baby boomers. In other words, younger consumers are more likely to find it inconvenient to travel to see their therapist of choice during preferred hours.

Younger patients tend to believe that telehealth can eliminate stigmas around seeking out behavioral health services. For example: If you live in a small town or college campus, running into someone you know in the waiting room can make you feel exposed or embarrassed. But logging into a session from the comfort of one’s home doesn’t carry that risk.

Accommodating New Patients
Given these generational trends, it may make sense for a behavioral health provider to look for ways to incorporate telehealth into his or her regular practice.

But therein lies a challenge for behavioral health providers: What kind of virtual services would a therapist offer? Which types of patient encounters are only appropriate in an in-person setting? And how would it change the scope of one’s practice?

It’s important to recognize that no two paths into telehealth are the same for any provider.

For therapists who work on college campuses and mostly with patients in their late teens to mid-twenties, there may be administrative restrictions on telehealth encounters. In some states or cities, there might be limitations imposed by insurance providers, or a lack of parity between in-person and remote consultations.

But for a psychologist whose clientele includes a lot of busy professionals with fewer administrative obstacles, expanding into virtual care might be as easy as offering extended hours on evenings and weekends. Incidentally, more flexible provider hours would also benefit behavioral health providers who are millennials themselves — and are seeking better work-life balance!

It’s also important to recognize that with any new patient, establishing trust upfront cannot be underestimated. Providers must ensure patients that they’ll receive the same care that they would in person. For some providers, giving a virtual tour of the office to physically show they are alone can comfort patients who might be skeptical about the telehealth consultation.

While in-person visits with mental health providers won’t go away anytime soon, behavioral telehealth is expected to surge, as younger patients seek convenient ways to engage with a provider to address mental health problems. The more thought providers can give to the overall telehealth experience, the better the experience will be for generations to come.

Photo: Motortion, Getty Images

Lindsay Henderson, PsyD is a clinical psychologist and the Director of Psychological Services at American Well, the nation’s largest provider of telemedicine services. Prior to joining American Well, Dr. Henderson was a staff psychologist at McLean Hospital in the Boston area and Clinical Instructor in Psychiatry at Harvard Medical School. McLean Hospital is the nation’s top psychiatric hospital, and here Dr. Henderson specialized in working with adolescents and their families, as well as supervising one of the hospital’s psychology postdoctoral training programs.

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