A Virtual Approach to Addressing Behavioral Health

Written by Jeff Carr and Irisha Greenwood

The COVID-19 pandemic was an unprecedented global crisis that left the world reeling, with behavioral health emerging as a repercussion for many, especially in the face of widespread sickness, deaths, and social isolation. Amidst the tragedy, the rapid deployment of telehealth programs became a silver lining, fundamentally transforming how health care is delivered and received. While some may argue that the pandemic served as a catalyst for telehealth's widespread adoption, the concept itself has been around for decades, quietly evolving in the background.

Long before this pandemic, Houston Methodist recognized the growing need for comprehensive behavioral health services. There is often a correlation between mental health challenges and overall well-being in patients, which can contribute to more complex medical care.  In response, Houston Methodist made a pioneering investment in 2017 by launching a 24/7 Telepsychiatry service across all its hospitals, including emergency rooms. This initiative was not a reaction to a global crisis but a proactive effort to address a critical gap in health care.

The Telepsychiatry program leverages advanced technology, including around the clock telepsychiatry coverage and devices such as iPads and mobile carts to seamlessly facilitate virtual psychiatric consultations. This approach allows for real-time consultation services, significantly enhancing patient care while relieving some of the burdens on hospitalists and emergency room physicians who typically see mental health patients. Since its inception, more than 40,000 telepsychiatry consultations have been completed, offering timely and effective mental health support to patients in need.

Blake Haren, M.D., FACLP, Medical Director for Telepsychiatry at Houston Methodist, emphasizes the importance of this program stating, “I am very excited about the potential for this technology to cover the increased need for mental health services in Texas. I believe that these platforms provide a form of ‘leverage’ that allows a smaller number of physicians to apply treatment across an incredible area. With this technology, we can now provide access to a care that doesn't just meet the needs of our patients but also has the potential to exceed expectations in terms of quality of care provided.”

Houston Methodist didn't stop at providing virtual behavioral care to hospitalized patients. In 2020, the Virtual Collaborative Care program was established within the outpatient setting. This innovative model involves a multidisciplinary team of social workers, psychiatrists, and primary care physicians working together to oversee patient care. Patients are referred to this program by their primary care physicians (PCPs), a process shown in research studies to significantly increases the likelihood of patients receiving the behavioral health care they need thanks to the strong physician-patient relationship¹.

Quality metrics from the Virtual Collaborative Care program demonstrate remarkable progress, with patient PHQ-9 and GAD-7 scores measured at both the beginning and end of the program. On average, the program has achieved 34% drop in PHQ-9 scores and a 26% reduction in GAD-7 scores, reflecting significant improvements in patient mental health outcomes. With over five social workers and more than 140 primary care physicians onboarded, Houston Methodist's Virtual Collaborative Care program has served an ever-growing number of patients. The success of this program reflects Houston Methodist's commitment to innovation and patient-centered care.

Houston Methodist's pioneering telehealth initiatives, including both Telepsychiatry and Virtual Collaborative Care, will undoubtedly serve as a model for others to follow. The combination of these services allows patients to be treated in the appropriate care setting for their health care needs.  These programs are a testament to the power of foresight and dedication in improving patient outcomes through technology and collaborative care.

Reference:

1.     Hilty DM et al. The effectiveness of telemental health: a 2013 review. Telemed J E Health. 2013 Jun;19(6):444-54. doi: 10.1089/tmj.2013.0075.