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'Telemental' Health is Trending Upward            

Research finds "telemental" health technologies are emerging to deliver mental-health services to employees in new ways. Experts extol the virtues of such approaches, but caution HR leaders to be mindful of the privacy concerns and other issues surrounding these services.

Wednesday, July 13, 2016
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It is safe to say that more companies are warming to the concept of telehealth.

Take, for instance, the National Business Group on Health's 2016 health-plan-design survey, which found 74 percent of large employers making telehealth options available to employees to the extent that they can. That number stood at 48 percent when the NBGH conducted the same poll in 2015.

And, it appears that these same companies are recognizing the role of mental health in employees' overall well-being, and are turning to technology to offer mental health services to the workforce as well.

Healthcare law firm Epstein Becker Green recently conducted a state-by-state analysis of legal issues related to telemental health, finding that new interactive audio and video platforms, computer programs and mobile applications are "driving [a] boom" in telemental health, with a "significant increase" in mobile applications related to mental health. The Epstein Becker Green report cites recent estimates suggesting that 6 percent of all mobile health applications developed are focused on providing mental health services to users, with another 11 percent devoted to offering stress management services.

The remote nature of telemental health makes it ideal for many workplaces, says Rene Quashie, senior counsel in Epstein Becker Green's healthcare and life sciences practice, and one of the study's authors.

"Telehealth seems to be a good fit for providing mental health services, because mental health providers rarely have to lay hands on their patients to provide care," says Quashie.

"Virtual care increases the ways in which individuals may access care, meaning that individuals need not always leave work to access services," he adds. "All in all, I think the appropriate use of telemental health services could go a long way in addressing the myriad mental health issues that may affect employees."

http://www.hreonline.com/images/ThinkstockPhotos-493219690telementalL.jpgStill, it's fair to say that a stigma still exists around those dealing with such issues.

Telemental health, however, may provide needed encouragement to employees who are hesitant to seek help from their employers in confronting those issues, says Amy Bergner, the Washington-based senior director of healthcare and benefits at PwC.

"I think it's probably a question of comfort for some, because maybe a person is more comfortable [addressing mental health issues] with a remote provider," says Bergner.

HR can play a part in helping to remove some of the barriers to seeking mental health treatment, adds Denise Heybrock, a Chicago-based senior health and well-being consultant at Aon Hewitt.

Running a mental-health awareness campaign and educating the workforce on the prevalence of mental health issues, for instance, "makes it more real for people, so that maybe they will seek help," says Heybrock.

"Individuals may be reluctant to disclose a mental health condition," she says, "because they're afraid they may be seen as weak, or may be judged, or may even lose their jobs. By offering this type of education, and these types of services, you're saying, 'We support you.' "

Beyond providing such support, HR leaders must also familiarize themselves with the legal and regulatory requirements surrounding mental health services, especially at the state level, says Quashie.

"Each state approaches regulation [concerning mental health services] differently, leading to a patchwork of sometimes-inconsistent laws and regulations among the states," he says. "And, while employers may not be directly liable regarding many legal and regulatory requirements, they need to be fully aware of the legal landscape [surrounding] telemental health."

Employers providing telemental health services in multiple states must understand the state-by-state issues involving privacy and security, follow-up care and emergency care, adds Quashie, noting that mental health data is subject to higher levels of protection in many states.

Maintaining employee/patient privacy is indeed paramount, and Bergner urges HR leaders to acquaint themselves with the Mental Health Parity and Addiction Equity Act of 2008. The legislation requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays and deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to medical or surgical benefits.

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"There are standards that have to be kept in mind," says Bergner. "The issue of privacy and confidentiality that exists in relation to face-to-face treatment has to continue to exist in the telehealth context."

Employers and HR professionals must also keep in mind that telemental health may not be the best answer for every employee in need of mental health services, says Heybrock.

For example, a mental health-services provider may prefer to evaluate an individual for signs of clinical depression in person.

"A provider may want to see the person's body language, the non-verbal cues, or even see if they're grooming, so that symptoms don't get overlooked," she says. "For that matter – and this might apply to those suffering from depression as well – getting out of the house [or the office] and engaging with someone face-to-face might be good for them."

As telemental health platforms become more commonplace, "providers are going to set some boundaries for themselves" in terms of the scope of services they provide via telehealth, says Heybrock. "And that impacts HR, because, when HR rolls out these programs, they have to make employees aware of a [telemental health] program's limitations as a clinical tool."

Ultimately, just how common telemental health services become in the workplace will depend on the results that organizations and HR leaders see, says Bergner.

"Just as HR departments are interested in outcomes and how well different treatments are working [to treat physical conditions]," she says, "they'll want to keep close tabs on the outcomes and patient satisfaction around this type of mental health treatment."

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