Hospitals, MedCity Influencers, Consumer / Employer

Let’s Focus on Behavioral and Mental Health in Rural Communities

In the next 12-18 months, healthcare providers — especially rural providers — have an opportunity to lay the foundation that will stem the volume of patients with mental health issues from going to the emergency room.

If there’s a silver lining to the past two years, the pandemic brought mental health to the forefront.

Studies show that one in five adults will experience a behavioral health disorder yearly. The number is almost certainly higher in rural areas.

Anxiety and depression rates among adults reached 42% during the pandemic, according to data secured by the National Center for Health Statistics in partnership with the U.S. Census Bureau.

About a fifth of the population lives in rural areas. While mental health issues aren’t necessarily higher in rural areas, rural residents receive less frequent mental health treatments and often have more limited access to doctors and counselors who specialize in mental health.

In rural communities, patients often go directly to the emergency room with mental health issues. Unfortunately, these hospitals’ emergency rooms often do not have a safe waiting area for psychiatric patients or patients in crisis.

Sometimes patients can wait hours before a hospital can find the right place. Unfortunately, this scenario diverts one or more nurses away from their primary emergency room or acute care responsibilities because they must stay with that patient one-on-one until the hospital can find somewhere for them.

This scenario often plays out in hospitals and compounds an existing problem.

Rural areas already struggle with an acute shortage of medical personnel and particularly nurses. With patients coming in with urgent, life-threatening medical issues, hospitals need their nurses to focus on those patients.

In the next 12-18 months, healthcare providers — especially rural providers — have an opportunity to lay the foundation that will stem the volume of patients with mental health issues from going to the emergency room. Instead, organizations can see these patients receive the help they need and deserve.

Telemedicine will be more prevalent

Amid the pandemic, rural mental health providers increasingly deployed telehealth to reach more patients. Organizations can use that technology to treat patients, schedule counseling sessions, and hold outpatient and one-on-one sessions.

Telehealth options took off as a “necessary evil” amid the pandemic. In the post-pandemic world, it will be necessary for survival and a bit easier to roll out from a staffing standpoint.

To deliver counseling — whether via telehealth or in-person — healthcare providers must find these qualified counselors out there that can conduct the actual telehealth sessions.

More than that, rural health clinics can relieve hospitals of the need to be the sole provider of mental health counseling for children or adults. These rural health clinics or their outpatient clinics serve as a route to provide health and care by using telehealth, bringing that telehealth into their outpatient offerings.

Furthermore, tapping into larger health systems — specifically, their psychiatric units — for advice and help will enable smaller providers to expand their offerings without increasing staffing and outlaying capital on new services.

While we’re making progress, building those bridges and making those connections takes time.

Growing the connection is paramount

One challenge with telehealth offerings is that not everybody has a computer or a reliable network connection. The good news is that nearly everybody has a smartphone, which has helped patients and providers stay connected.

The federal government has allocated billions of dollars to expand broadband connectivity. Moving forward, some healthcare providers may take a more active role in advocating for the expansion of reliable broadband in rural areas to ensure telemedicine becomes an even more viable option for underserved communities.

As community leaders, healthcare providers and perfectly positioned to advocate for this expansion.

Increased use of analytics will help predict outcomes

Perhaps the most significant trend we’ll see in the next 12-18 months is the increased use of analytics to predict patient outcomes.

Incorporating analytics into enterprise resource planning (ERP) systems allows organizations to monitor and capture data better. That will help organizations gain more insight into where the shortfalls are and what we need to do to improve.

This insight improves strategic planning because organizations can look at those numbers for a more complete picture of what’s happening.

Smaller rural hospitals benefit from ERP systems to help them survive, but since the implementation of ERP systems, I see these hospitals using data more often to capture what’s happening with trends and growth in their marketplace. This technology helps organizations manage their financials and see the bigger picture of what’s happening and what is needed.

For example, I’ve seen this technology specifically benefit diabetic populations in rural areas. Recent trends show that the diabetic population is climbing in rural areas. Now healthcare providers can use technology to help decide whether they need to bring on board diabetic counseling or teach classes with a nutritionist.

Technology can be applied in the same manner to mental health. It helps inform organizations where their shortfalls are and where they can add or enhance services.

More conversation means more clarity.

Ideally, every small town in America would have a psychiatrist. Many rural hospitals are integrating these services into their practices, recognizing the need for psychiatric services. These expansions include adding geriatric psychiatry units to help older populations.

While the expansions are helpful and much-needed, they won’t change the situation overnight. It’s a process that takes a while to develop and hire and train the staff, and organizations still need a medical director and a psychiatrist to oversee it.

Everything won’t be solved with staff, but it certainly will make a good step.

Mental health often isn’t talked about in rural areas. Unfortunately, it still carries a stigma and all the technology in the world won’t change that.

Solving the mental health crisis in rural areas still comes down to people acting — no action is too small.

If there’s one change in the next 12-18 months, let’s hope there’s an increased awareness and openness to talking about mental health, especially in our rural communities.

We’ve already done the hardest part: bringing it to the forefront. Now, we just need to see it over the finish line.

Photo: marekuliasz, Getty Images


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Baha Zeidan

Baha is the Co-founder and CEO of Azalea Health, a leading healthcare IT company whose mission it is to help underserved healthcare providers improve patient care and profitability. Under Baha’s leadership, Azalea has established itself as a high-growth innovator and leader, developing a comprehensive, cloud-based health IT platform for ambulatory practices and hospitals -- including introducing the industry’s first fully-integrated proprietary telehealth solution with its EHR.

Azalea Health has achieved Inc. 5000 rank of fastest-growing companies in the U.S for three consecutive years and has been named a Top 40 Innovative Technology Company by The Technology Association of Georgia (TAG).

Baha has been recognized in the industry with a number of awards including the Phoenix Award by the Metro Atlanta Chamber Bioscience-Health IT Leadership Council in conjunction with the Health IT Leadership Summit for his outstanding contribution to the growth of the health IT industry in Georgia. He is also a 2018 recipient of the Atlanta Business Chronicle’s 40 Under Forty Award and a 2019 recipient of their Most Admired CEOs Award.

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