Introduction
Similar to adults, children also encounter many mental health challenges. According to the latest statistics, almost 20% of youth experience some mental health-related problems and have a mental, behavioral, or developmental disorder (MBDD) (Centers for Disease Control and Prevention [CDC], 2019; Delaney, Burke, DeSocio, Greenberg, & Sharp, 2018). Nonetheless, many of these young people cannot access professional treatment due to a variety of reasons. Delaney et al. (2018) approximate that nearly two-thirds of the US youth population with MBDDs have problems with receiving care. This calculation reveals a major issue in the health system that puts vulnerable youth at risk of adverse outcomes. Therefore, policy change is necessary to improve the national infrastructure and children’s health.
The current research paper considers the policy of telehealth for improving rural communities’ access to mental health services. First, the background of the problem will be introduced, showing how the lack of professional care may impact young people’s lives. Then, a literature review will demonstrate the policy’s potential strengths and weaknesses. Financial considerations will be considered for patients, organizations, and the health system as a whole. The impact of the policy, as well as its effectiveness, will be appraised in the end. Overall, this essay will aim to show the potential of using telemedicine as a resource for children from underserved populations.
Background
In order to understand the severity of the problem, one may look at the existing data about children’s mental health. As stated above, nearly 20% of the youth population encounter mental health-related challenges. This percentage indicates that 1 in 5 children need professional help to avoid complications or experience additional distress from untreated conditions. MBDDs may include attention-deficit/hyperactivity disorder (ADHD), depression, anxiety, disruptive behavior disorder, Tourette syndrome, autism spectrum disorder, learning and intellectual disabilities, speech and language problems, and others (Centers for Disease Control and Prevention [CDC], 2018; CDC, 2019). The time of diagnosis and treatment can determine the effectiveness of medical help – children who are diagnosed early are at an advantage (CDC, 2018). Therefore, it is vital to provide appropriate assistance to as many young patients as possible.
This notion introduces a problem in territories where medical care is low in quality. In rural areas, there exists a lack of healthcare providers, especially pediatric mental health professionals (Kelleher & Gardner, 2017). According to Kelleher and Gardner (2017), this concern is further exacerbated by the fact that rural children are more likely than youth from urban areas to have an MBDD. As a result, the combination of these factors as well as the small communities’ financial limitations and mental health stigma, many children experience difficulties that are not addressed on time.
The adverse consequences of inappropriate, untimely, and missed treatment are serious. First of all, the lack of attention to these issues may raise the level of suicidal thoughts and attempts (Miller et al., 2017). Second, untreated MBDDs affect children’s academic performance, leading to increased rates of alcohol and drug abuse, family problems, and violence. The impact of mental and physical fatigue is long-lasting, and children who encounter stigma are further deterred from seeking help (Delaney et al., 2018). Overall, negative attitudes and insufficient resources contribute to the escalation of the youth’s health issues.
Literature Review
The idea of using telehealth to broaden the health system’s reach to underserved populations has been addressed in scholarly literature. Foster, Agrawal, and Davis (2019) review the potential of telehealth for treating children with medical complexities. The authors argue that telemedicine (medical treatment and information transfer using electronic communications) enables opportunities to resolve such problems as the workforce gap, inefficient pediatric focus, and remote patient monitoring (Foster et al., 2019). While they do not consider mental health only, their findings indicate that the lack of children-specific professionals can be overcome with telehealth services that will connect children from underserved areas to qualified providers. The recommendation to include telehealth as a way of delivering mental health services is present in recent studies. Delaney et al. (2018) suggest to expand telehealth services for pediatric providers and integrate it into hospitals that do not have enough resources for on-site care. The authors also list several other possible solutions that target education and stigma rebuttal.
The main strength noted by researchers discussing telehealth is the ability to connect providers and patients from different locations. Miller et al. (2017) state that the increasing access of people to technology makes the option of mHealth and eHealth more plausible than before. As many people, including the youth, possess a smartphone or a computer, they can connect with clinicians online. Moreover, telehealth solves the problem of convenience for some individuals. Communities located in remote areas need to travel long distances to receive appropriate care. Telemedicine eliminates the need for travel, thus lowering expenses and time spent. As an outcome, patients may be more satisfied with the convenience and speed of telehealth-supported interactions.
Nonetheless, some weaknesses of telehealth policy exist as well. The lack of supporting literature about the policy’s effectiveness on children’s mental health is noted by So, McCord, Kaminski (2019) who urge future studies to explore the subject further. The CDC (2019) raises such issues as the possible high costs of equipment installation, rental costs, salaries, wages, administrative expenses, data transmission costs, and other fees. Thus, the main concern is financial and is directed at the first stages of the policy’s integration. Apart from that, it is possible that telehealth will not be regarded as adequate by patients, increasing non-compliance, and resistance to treatment.
Financial Comment
The policy of “telemental health services” can benefit many areas in the country, thus requiring sufficient funding to be introduced nationally. The CDC (2019) outlines several streams that may assist in this case. First of all, it should be noted that the provision of telehealth is governed by state and federal laws. Thus, it may be expected that the government will be one of the major supporters of the project. The Centers for Medicare and Medicaid Services (CMS) can introduce new options to increase the use of telemedicine in the US. Currently, some reimbursements are provided in a number of states. Federal and local grants to support the improvements of rural healthcare are other funding sources for the policy. Most of these grants are sponsored by national offices and health care foundations.
Insufficient funding will undermine the effectiveness of the intervention and slow down its integration into the health system. Telehealth requires installing devices and training clinicians to use them. The lack of financial support will result in limited resources and unprepared staff. Moreover, if hospitals choose cheaper options for hardware and software, this may raise another concern – the privacy of patient information. Telemedicine should ensure a high level of confidentiality for patients, and the lack of funds may undermine the ability of healthcare providers to guarantee data safety.
Policy’s Defense
Based on the presented facts and academic research, I support the discussed policy. It is apparent that technology is a part of people’s everyday lives, and its role in many activities grows continuously. Therefore, it is reasonable to consider telehealth as a continuation of this phenomenon and utilize technology in medical care. The policy considers rural communities and populations whose lives may be strongly impacted by timely care. It was demonstrated that there exists a lack of mental health care professionals in remote locations, and clinicians with specific knowledge of the youth population is even smaller. Telehealth makes this problem less severe, connecting providers and clients regardless of their place of living.
Furthermore, this policy has some strengths that are reliant on the new younger generation’s skills. Children’s understanding of technology is advantageous since it removes barriers that may raise problems for older generations. The stigma related to mental health care can be overcome because the conditions of receiving telemental healthcare can be gamified or made private with the help of mobile applications. The variety of telehealth approaches creates a system of options for children to ensure convenient long-term treatment. The limitations of these opportunities are resolvable, and telehealth should be used to improve children’s access to mental health care.
Populations
The introduction of telemental health services will primarily influence the wellbeing of children from underserved populations. These may include communities from remote locations and minorities as well as people with low income. Notably, children with limited mobility an MBDDs may also benefit from using telehealth. Telemedicine eliminates the need to travel long distances, thus increasing access to care for people who live far away from the necessary clinics. The successful implementation of the telehealth policy may significantly lower the rates of negative consequences in underserved populations, including suicide and self-harm. It can improve children’s academic performance and reduce related stress.
Indirectly, this policy will also change the clinician-patient caretaker interactions. Parents and guardians who are often responsible for children with MBDDs will no longer have the same traveling expenses, saving time and money for other needs. The use of smartphones may eradicate the needs to visit the hospital often, also lowering possible anxieties and tensions. Furthermore, mental healthcare professionals will be impacted by the policy as well. The introduction of telehealth will require participating professionals to undergo training and receive a license depending on the state’s laws. Thus, all involved professionals will gain new knowledge, broaden their experiences, and change their working schedule.
Effectiveness
Some evidence of telehealth’s effectiveness exists, but the focused approach of telemental health for young people is not currently supported by research sufficiently. According to the CDC (2019), the benefits of telemental health services have been proven for such underserved populations as rural Americans. Moreover, one study supported the argument that such technology can help children with ADHD (CDC, 2019). A number of research articles suggested that telehealth is helpful, however, the technology used in them is rather outdated. At the present moment, telehealth significantly differs from that which was used twenty, ten, or even five years ago.
Therefore, more research is necessary to examine the outcomes for children who use telehealth. Researchers such as Miller et al. (2017) and Delaney et al. (2018) provide some foundations for the future research and show how the value of telemental health services can be measured and improved. The CDC (2019) also note that the use of telemedicine is increasing among both adults and children and that the barriers to pediatric use can be overcome. The prospects of this policy demonstrate that it can be helpful with proper funding and training.
Conclusion
Approximately one in five children in the US encounter mental health problems and a major portion of them cannot access treatment to deal with increasing challenges. Young people’s inability to get diagnosed and treated leads to other issues, including worsened academic performance, stress, family conflicts, violence, and substance abuse. Thus, the health system should consider ways of delivering care to underserved populations. One of the proposed policies is the integration of telemedicine, or telemental health services into pediatric mental healthcare for rural Americans and other vulnerable communities. This project implies that remote locations will be connected with necessary professionals through computer and mobile devices both in and outside of local organizations.
The effectiveness of telehealth is growing together with the role of technology in people’s lives. The younger generations’ acceptance of various devices can be beneficial in the process of telehealth introduction. The problems of incorporating telehealth are mostly financial since they deal with the costs of installation, maintenance, and training. The existing academic research suggests that telehealth is effective for addressing the needs of underserved populations, although some additional studies are recommended. All in all, telemedicine can substantially improve children’s access to mental health services and provide them with an option that is not limited to certain locations medical environments.
References
Centers for Disease Control and Prevention. (2018). Providing access to mental health services for children in rural areas. Web.
Centers for Disease Control and Prevention. (2019). Children’s mental health: Improving access to care. Web.
Delaney, K. R., Burke, P., DeSocio, J., Greenberg, C. S., & Sharp, D. (2018). Building mental health and caring for vulnerable children: Increasing prevention, access, and equity. Nursing Outlook, 66(6), 590-593.
Foster, C. C., Agrawal, R. K., & Davis, M. M. (2019). Home health care for children with medical complexity: Workforce gaps, policy, and future directions. Health Affairs, 38(6), 987-993.
Kelleher, K. J., & Gardner, W. (2017). Out of sight, out of mind — Behavioral and developmental care for rural children. New England Journal of Medicine, 376(14), 1301-1303.
Miller, P., Ryer, J., Hodder, L. C., Doyle, M., Garin, H., Humer, M.,… Thomas, J. (2017). Telehealth and mobile health applied to integrated behavioral care: Opportunities for progress in New Hampshire. Institute for Health Policy and Practice (IHPP), 3. Web.
So, M., McCord, R. F., & Kaminski, J. W. (2019). Policy levers to promote access to and utilization of children’s mental health services: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research, 46(3), 334-351.