Digital Interventions: Closing the Treatment Gap in Behavioral Health

From geography, socioeconomics, and culture to gender, race, ethnicity, and age, there are many variables that can influence the treatment and recovery of substance use disorders and mental illnesses. Evaluating the effectiveness of services, treatments, and support can be challenging when there are disparities in care.

However, it’s critical to explore the treatment gap in behavioral health and mental health in order to improve it. Let’s delve deeper into how behavioral health and human services professionals can use digital interventions to address the barriers to care and close treatment gaps.

Managing the Treatment Gap in Behavioral Health and Human Services

In the context of behavioral health, the treatment gap is the percentage of people who need behavioral health services but do not receive them. Globally, the treatment gap for mental disorders exceeds 50%, reaching 90% in low-income countries. Only 65.7% of North Americans diagnosed with moderate or severe mental illnesses receive treatment. 

Regarding human services, the numbers vary by state. Still, we know that some Americans living below the poverty line are eligible for but do not receive assistance from the U.S. social safety net. 

Disparities play a role too. Compared to the general population, minorities are less likely to seek mental health services and often leave treatment too soon. Minorities are more likely to utilize psychiatric emergency services but less likely to receive outpatient follow-up after discharge. And due to their sexual and gender identities, LGBTQ+ patients experience more stigma and discrimination, social exclusion, and violent abuse.

Lack of insurance coverage, high-deductible health plans, social stigma, a shortage of behavioral health clinicians, and limited services in rural areas are some of the most common external barriers to treatment. Lack of knowledge or insight and ambivalence are common internal challenges. Digital health interventions offer a way to conquer these challenges plus reach disparate and underserved communities with much-needed behavioral health and human services.

What Are Digital Interventions?

Although digital therapeutics have been applied to many health domains, they have been incredibly transformative in the field of behavioral health, including mental health and substance use. Research demonstrates their robust and replicable effectiveness for behavioral health. Digital interventions include digitally delivered programming such as teletherapy, contingency management, shared decision-making, patient education, and peer support. 

How Digital Interventions Close the Treatment Gap

In a world where almost everyone has access to mobile phones and online devices—often within arm's reach—and where high-speed access continues to grow exponentially, digital health interventions are positioned to transform behavioral health access. 

Digital treatments can potentially expand the reach of behavioral health professionals and provide care to individuals who might otherwise lack access to it. The benefit of e-health technology includes accessing mental health care anytime and anywhere. 

Digital therapeutics may also free up providers' time to treat more individuals and reduce long waiting lists for care. Treatment programs based on digital technology can also overcome many transportation barriers associated with traditional treatment programs because they transcend geographic boundaries and provide on-demand therapeutic support. Furthermore, since some digital interventions do not require synchronous (real-time) communication with a clinician, they overcome many time constraints.

Health research from the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that therapeutic support delivered through digital platforms may be less stigmatizing than traditional behavioral health care models. In addition to more individuals seeking mental health care, it may result in patients entering care earlier. Consequently, a mental health challenge may be prevented or diagnosed earlier. 

Also, according to SAMHSA, digital behavioral health interventions are well-poised to tackle the cost barrier many patients experience in traditional models of care. Although implementing evidence-based digital therapeutics has an upfront development and evaluation cost, the cost to maintain them is far less than that of clinician-delivered care in behavioral health care settings. Of course, this is not to suggest that web-based digital therapeutics should replace traditional behavioral health care models. Rather, it underscores the utility in enhancing the cost-effectiveness of some treatments. 

Among the most recent advances in digital behavioral medicine is the advent of digital behavior change interventions (DBCIs). Here, digital technologies are used to promote and support behavior change to prevent and manage health problems like obesity in adolescents.

Types of Digital Interventions for Behavioral Health

Evidence-based digital interventions can help improve health outcomes by making patients active partners in their own health care. As mobile health (mHealth) engages users, it can help improve health outcomes by making patients active partners in their own health care. Here’s a look at several types of digital health interventions that can help support healthy behavior changes.

Direct Channel Telehealth

Telehealth is the most recognized digital intervention, which saw its biggest uptake during the pandemic. Not only is telehealth a billable service, but it’s also regarded with high levels of patient satisfaction. What’s more, telehealth comprises multiple methods and tools that use telecommunication, mobile apps, and digital technologies to support long-distance behavioral health therapies, behavioral health education, and behavioral health administration. 

Telehealth is also gaining popularity as a methodology for conducting randomized controlled trials, scoping meta-analyses, data collection, acceptability and feasibility studies, clinical trials, and other internet-delivered clinical research. 

There are two types of telehealth: synchronous and asynchronous. 

Synchronous Telebehavioral Health

Synchronous care occurs in real-time and is the most common form of direct-to-patient telemedicine. During synchronized telebehavioral health, a patient interacts with a provider directly over the phone or through videoconferencing. Much like face-to-face visits, clinicians perform assessments, consultations, diagnoses, treatment plans, follow-ups, and prescription services. 

In addition to cameras and audio equipment, at-home devices can be used to facilitate real-time telehealth visits. These may include vital signs monitors, scales, drug and alcohol testing instruments, and medication delivery systems to help providers assess treatment compliance. In addition to diagnosing mental health problems, behavioral health professionals may use direct telehealth to deliver many psychiatry and psychotherapy methodologies, such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), consult with primary care providers, and observe the physical activity of patients.

ContinuumCloud’s mobile patient engagement platform, powered by CaredFor, offers direct channel telehealth communication for telehealth communications. Patients can even initiate a telehealth call from an intuitive interface.

Asynchronous Telebehavioral Health

Asynchronous telehealth refers to patient support services that start as one-sided communications, such as email, text messaging, and live chat. The CaredFor app provides both a customizable design and HIPAA-compliant channels for the delivery of asynchronous telebehavioral health communications. Asynchronous telehealth messages can be automated and scheduled using ContinuumCloud's electronic health record, which is also HIPAA-compliant. 

Personalized Care Journeys

Integrating clinical care plans into a digital format allows care providers to create highly-targeted, engaging patient journeys. ContinuumCloud’s Care Journeys supply patients with a computerized roadmap with personalized notifications, treatment goals, milestones, and more. When patients need more support, their Care Journey will include links to the available tools and resources. 

Patients can access Care Journeys through the CaredFor app. Utilizing ContinuumCloud automation, the module allows providers to deliver individualized digital experiences at predetermined intervals to each patient based on their health needs. When integrated into the remote care experience, Care Journeys are simple digital interventions with enormous impact.

Curated Patient Education Content Library

It’s imperative that patients have access to trusted information so they can make informed decisions. Although the internet offers easy access to information, the quality and accuracy may vary widely. The CaredFor app allows you to choose which content your patients and alumni can access. ContinuumCloud works with you to create a digital education library with a content range that complements your programming style.

Contingency Management (CM)

The goal of contingency management is to motivate patients to make positive changes through engagement. The more time and effort a patient invests, the more likely they are to participate in their own health care. The ability to abstain from drugs or alcohol over an extended period can be a strong predictor of sustained recovery. Boosting engagement may help patients adhere to their treatment plans longer.

CM is an effective tool for spurring individuals to change their most resistant behaviors. Achieving success fosters confidence over time, helping patients overcome self-blame and guilt.

Patients and alums can earn points and rewards for interacting with the CaredFor app’s contingency management features. Goal setting and achievement, maintaining connections with peers on the app, attending teletherapy, and answering survey questions are all ways patients can earn points. CaredFor provides the infrastructure, and as the program director, you choose the rewards.

Surveys and Questionnaires

The CaredFor app uses micro-interactions to deliver 1- to 2-question surveys to improve patient engagement. You can use surveys as a digital intervention whenever you check in on a patient between treatments or follow up after an appointment. Use surveys for data collection when developing valid outcome measures. Self-evaluation surveys are also available. Patients benefit from these because they help them understand their progress.

Goal and Milestone Tracking

When properly implemented, goal-setting programs are effective in behavior change and emotional management. Patients can use the CaredFor app to map their goals and track important milestones. This digital intervention encourages patients to share their progress with their peers to maximize engagement.

Peer and Alumni Support Programs

Behavioral health patients benefit significantly from peer support. You can gain insight into how to promote mindfulness and well-being by observing how the patient interacts with peers. Patients learn coping skills that bolster resilience by sharing perspectives and experiences with their peers.

The CaredFor app’s online peer community fosters connections between people experiencing or having gone through similar situations. Other digital interventions are virtual support groups within a social-media-type environment. The CaredFor app offers a safe, monitored environment that allows patients and family members to connect 24/7 from any device.

It’s easy to build an alumni program using the CaredFor app. A digital intervention like this keeps patients connected to your practice and committed to their recovery. The CaredFor app includes features for patients who’ve completed a therapy program, their caregivers, and family members.

Reach Patients and Improve Outcomes With Digital Interventions

Healthcare systems worldwide face the challenge of unmet mental health care needs or the large gap between mental health needs and treatment availability. Research has demonstrated the baseline treatment gap and has aimed to understand how it affects the quality of life, worsens mental health conditions, and negatively impacts health outcomes. But until recently, there has been no real solution.

Today, behavioral health care systems can leverage mobile health technology to deliver digital health interventions to patients who may not otherwise have access. Digital interventions, including telemedicine, offer clinicians a way to provide care, enhance self-management, and improve patient outcome measures through a smartphone app like CaredFor. Connect with us today to learn more about implementing these effective interventions for your practice.