More people need mental health treatment today than ever before, but there simply aren’t enough therapists to meet the growing demand.
In 2020, it was estimated that around 41.4 million adults in the US received mental health treatment or counseling. Only about 106,500 psychologists hold current licenses in the United States.
An avalanche of digital health apps has hit the market. Many of these, however, are designed to be low intensity and low contact; are mental health apps and tools that guide mindfulness and meditation or don’t require a doctor’s touch. And while telehealth has helped provide widespread access to high-touch treatment, virtual care is still limited by a shortage of therapists.
Virtual reality is the “goldilocks” the mental health industry has been waiting for, says Risa Weisberg, clinical director of mental health technology provider BehaVR, a licensed clinical psychologist, and an expert in cognitive behavioral therapy. She is also a professor of psychiatry at Boston University School of Medicine and an adjunct professor of family medicine at Brown University.
Healthcare IT News sat down with Weisberg to talk about what telehealth can’t do to cure the therapist shortage, how virtual reality works in mental health care, why he thinks virtual reality is the perfect answer to the staffing problem, and how virtual reality can provide access to alternatives to pharmacological treatments such as opioids
Q. Telehealth has certainly made mental health care available to many more people. Where, in your opinion, does telehealth fall short?
A Telehealth can remove potential barriers to access for patients, such as geographic location or transportation to an appointment. As such, telehealth can often make it easier to find a therapist, as any therapist licensed in the state in which the patient lives may now be a potential option.
Additionally, you can increase access for patients with busy schedules, who may have time for a 50-minute appointment but not travel to and from a therapist’s office, and for patients with mobility difficulties.
These are all really positive contributions. Unfortunately, what we are facing in the behavioral health space right now is a severe shortage of professionals, something that telehealth does not solve.
As a psychologist, I can personally attest to how difficult it has been to find colleagues with openings for new patients in recent years. However, the limited number of trained therapists, particularly therapists trained to provide empirically supported psychotherapies, was a problem long before COVID-19.
We just never had enough suppliers to meet the demand. Now, due to the pressures of the pandemic, the need is greater and the supply may be decreasing as many therapists are leaving the field due to burnout.
We are simply not enough to meet the current demand for quality mental health care, leaving many patients desperate to find a provider or facing months-long waiting lists for an appointment.
Telehealth may ease the burden of traveling to your therapist’s office, but it doesn’t create new capacity within the industry. What we need are new, sustainable solutions that bridge the gap between the growing number of patients seeking mental and behavioral health treatment and the number of qualified professionals trained to deliver that care.
Q. What is virtual reality technology and how does it work in mental health care?
A Most digital health experiences right now are two-dimensional. When we interact with our smartphone or laptop, our brains process those experiences in the same way, i.e. it’s not happening to me, it’s something I’m reading or watching.
VR replaces your sensory input, creating an immersive experience that your brain processes more like a whole new reality. It is as if everything you are seeing and hearing is actually happening to you. This level of engagement means that experiences in virtual reality are processed by your brain in the same way as real experiences.
The ability to activate neural processes in this way is incredibly useful for implementing well-understood therapeutic techniques to address behavioral and mental health issues. Virtual reality gives us the ability to transport someone to a quiet and peaceful place for a meditation session, removing distractions from the outside world and improving focus of attention.
Importantly, we can also create environments deliberately designed to arouse and challenge people as part of exposure therapy. In fact, exposure to feared situations, including flying, heights, and even combat, is one of the most studied and applied uses of virtual reality for mental health.
Q. You’ve said that virtual reality is “Goldilocks’ mental health needs.” Please elaborate.
A We have seen an incredible rise in digital health solutions aimed at bridging the gap in mental health care in recent years. Many companies have created platforms to find and offer telehealth psychotherapy sessions.
These solutions are high-end in the sense that while in-person care is not needed, a licensed physician is still required to be present synchronously for all patient care and therefore do not extend the scope of our limited mental health staff.
Solutions at the other end of the spectrum, such as smartphone apps, have also proliferated in recent years. Many of these companies are doing a fantastic job and, like telehealth, have played a big role in the space.
Most of these phone app solutions are designed to be used independently, often without a doctor’s supervision. Therefore, these low-touch solutions do an excellent job of addressing the shortage of mental health professionals by offering people seeking mental and behavioral health support options that do not require a provider.
However, because most of us can be easily distracted when using our phones, and because the apps we interact with on our phones aren’t fully immersive, the impact of these interventions may be limited for people who need it most. than low-intensity activities. watch out.
Virtual reality experiences built on the foundations of empirically supported psychotherapies may provide an ideal solution. These experiences, because they are fully immersive and processed as if they were actually happening to you, promise to potentially show clinical effectiveness that may be more comparable to some in-person therapy, but with the flexibility of being used without a doctor. . Present.
Whether it’s wellness products that people use entirely on their own, or prescribed VR programs where a doctor is involved in care but doesn’t need to be present in sync during all sessions, VR could be the hybrid solution or Goldilocks that the industry needs. scale mental health services without adding a new burden to current providers.
P. You also suggest that virtual reality can give access to alternatives to pharmacological treatments such as opioids. How?
A First, it’s important to note that virtual reality will never completely replace drugs or in-person therapy. There are use cases that may require pharmacological interventions and/or traditional psychotherapy in the office. However, for some people and some behavioral health indications, VR interventions can be equally strong treatment options.
One of those areas is pain care. VR interventions can be effective in addressing and reducing pain, both as a stand-alone solution and as an adjunct to physical therapy and other methods of pain management.
A good deal of research has explored the use of VR to provide distraction and/or relaxation during episodes of acute pain, making it a promising alternative to the use of opioids in acute and post-surgical care.
In a 2021 review of virtual reality applications in military and veterans healthcare, researchers reported, among other findings, a 39% reduction in the total dose of opioid medications used for patients receiving a virtual reality intervention during burn wound care. The authors suggest that virtual reality could provide a scalable, non-opioid pain relief solution for soldiers recovering from combat injuries in the future.
Additionally, more recently solutions have been developed to address chronic pain through virtual reality interventions. These programs often incorporate mindfulness strategies, relaxing settings, and/or breathing techniques to activate the patient’s parasympathetic nervous system and relieve pain over time.
VR interventions have also been developed to help people better understand their chronic pain and reduce their tendency to catastrophize their pain and/or encourage exercise in patients who have developed a fear of pain and movement.
In the midst of the opioid epidemic, virtual reality interventions for acute and chronic pain could decrease the number of opioid medications prescribed and potentially lead to fewer problems with medication use in the future.
Additionally, VR interventions are being developed to directly address opioid use disorder, using evidence-based treatment methods.
Overall, I think we’re in the midst of a huge transformation in how most people view their mental health and access care. The pandemic has taught many of us how crucially important our mental health is and how difficult it is to access high-quality, evidence-based care.
Similarly, virtual reality as a technology has been growing rapidly in recent years with a greater ability to create fully immersive experiences and at a more affordable price. I believe that the synergy of these two changing fields will lead to more powerful solutions and a plethora of behavioral health care scenarios to which virtual reality solutions can be applied.
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