Mental health care is in high demand. Psychologists are leveraging tech and peers to meet the need
Ninety percent of the public think there is a mental health crisis in the United States today, with half of young adults and one-third of all adults reporting that they have felt anxious either always or often in the past year, according to a 2022 survey conducted by the Kaiser Family Foundation and CNN. One-third of respondents could not get the mental health services they needed. When asked about the specific barriers to accessing care, 80% cited cost and more than 60% cited shame and stigma as the main obstacles. The shortage of mental health providers is also prohibitive, with 60% of psychologists reporting no openings for new patients, according to APA’s 2022 COVID-19 Practitioner Impact Survey.
Mental health providers throughout the country share a sense of urgency to find new ways to meet the high demand for services, and innovators are exploring interventions that diverge from traditional therapy models. The creative approaches include forms of support that require less time commitment from individuals, can be offered through digital devices, or both. Clinicians and researchers are seeing the benefits of these strategies in settings such as community clinics and college campuses, where psychologists experience a duty to serve and patients are open to exploring new options to access help.
“The lack of access to mental health care is an equity issue,” said Martyn Whittingham, PhD, a licensed psychologist in Ohio who developed a brief group therapy intervention. “Too often people from marginalized communities struggle to access quality psychotherapy, and these innovative strategies can provide support to many more people.”
The use of mental health apps continues to skyrocket. Certain apps, such as digital therapeutics, can cost between $300 and $1,500 per year and are typically not covered by insurance. Psychologists are advocating at the state and federal level for health insurance organizations to cover the fees. Even though digital therapeutics have significant potential, psychologists are also “still figuring out how to use these tools in the context of clinical workflows,” said Stephen Schueller, PhD, an associate professor of psychology at the University of California, Irvine. “Evidence suggests that people benefit most from digital therapeutics when the apps are used in conjunction with some form of human support.” People may need coaching to troubleshoot technical problems and check-ins to see if symptoms are improving, he said.
Digital therapeutics could play an important role in providing support for underserved communities—specifically, people who speak languages other than English. But most mental health apps are only available in English. The Latinx community represents the largest non-White community in the United States, yet only 14.5% of mental health apps studied in a recent literature review had Spanish-language operability (Muñoz, A. O., et al., Frontiers in Digital Health, Vol. 3, 2021).
Schueller recently launched a study using a digital therapeutic called SilverCloud that offers cognitive behavioral therapy skills and practice exercises to help people address anxiety, depression, insomnia, and other issues. His team is using the Spanish-language version and training Spanish-speaking laypeople from the community to coach monolingual Spanish-speaking patients to use the app effectively. Schueller’s team is exploring how the addition of human support to the SilverCloud intervention impacts clinical outcomes and engagement with the app and how to best integrate this digital therapeutic into care delivery.