Virtual Mental Health Care During the Pandemic: Why Providers Must Prepare for Increased Exposures

As patients and providers become more digitally connected, greater dependency on technology increases privacy and security concerns.
By: and | October 23, 2020

The pandemic has contributed to a rise in mental health concerns as people are experiencing increased stress regarding health and finances, isolation and loneliness. According to a recent report by the Society of Human Resource Management, 45% of employees feel emotionally drained from their work during the pandemic.

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The crisis has piled on pressure at a time when mental health globally was already in a fragile state. With ongoing social distancing requirements, many have turned to virtual health support and self-care technology options, driving health providers to rethink how they engage with patients.

The move online has challenged both users and providers of mental health care to adapt quickly to different forms of health care and ensure patients receive the care they need despite the reduction of in-person services.

It is a dynamic, fast-growing sector. The general expectation is that the current spike in tele-mental health services will persist beyond the current crisis, with one recent report estimating the value of the tele-psychiatry market at $36bn by 2027.

Patients seem to be largely receptive: 81% would “definitely” or “probably” access treatment and support via a virtual channel, according to a U.S. survey of people with behavioral health issues conducted during the pandemic by Accenture.

As more organizations provide online services, the risks need to be fully considered up front.

Jennifer Schoenthal, underwriter miscellaneous medical & life sciences, Beazley

This area of treatment arguably lends itself better than most to remote provision, however, the differences between the virtual setting and the clinic are worth close consideration for both seasoned tele-mental health providers and newer providers.

Digital health often brings new and unforeseen interconnected risks, not just for diagnosis, treatment and care, but also in terms of technology, data privacy and compliance.

Breaking Down Borders

While a key strength of this is accessibility and being able to use services wherever and whenever you want, key risks include regulatory and licensing as well as the impact of deferred in-person treatment.

Regulatory considerations must be addressed up front.

Although many regulatory bodies have taken steps to relax licensing restrictions during the pandemic to support ease of access and treatment, the rulebook is constantly changing. Providers need to keep up-to-date and avoid running afoul of an evolving regulatory landscape.

At times when a virtual consultation must shift gears, health professionals need to be sure that distance does not prevent or delay in-person human intervention, if required, as consequences could be severe.

Tele-mental professionals delivering remote consultations may be reliant on third parties or networks in other states to ensure there are nearby responders who can physically reach patients. This arrangement requires established communication channels and protocols.

In some cases, the patient may be at-risk if an in-person intervention is needed but does not occur, leaving providers exposed to allegations of malpractice.

Blurred Boundaries

Risks that some might assume were confined to in-person treatment can also arise in a digital setting.

Likewise, professional misconduct — such as allegations of inappropriate behavior by a professional towards a client — can arise in a virtual setting, too.

Kyle Laudadio, underwriter, Private Enterprise, Beazley

In one such incident, a marriage guidance counselor instigated a relationship with a client online that led to a claim of negligent misconduct. In this area, the responsibility of organizations to ensure compliance with procedures and codes of conduct is as stringent online as offline — and the penalties just as severe.

Adopting New Methods of Care

In addition to interactive therapy, the pandemic has also resulted in more people turning to apps and other online platforms to support their mental health and wellbeing. Today, an estimated 20,000 mental health apps are available, as well as many more focused on broader wellness and lifestyle.

Along with greater integration of telehealth and remote monitoring, generally, increased integration of apps into therapeutic care is also anticipated. Some therapists encourage patients to use an app to monitor and grade their symptoms with output shared and discussed during an online therapy session.

With the convenience and improved access to services comes the added risk that data could be lost, accessed or shared without authorization, either maliciously or through human error.

Ensuring the security and privacy of the app or website and the storing and sharing of health information requires an up-to-date cyber security strategy and risk management approach.

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It is important that all providers make sure employees receive regular training on systems and security. They also must be aware of the adequacy of disclosure about the risks and benefits of tele-mental health, as well as the requirement to obtain and record patients’ informed consent.

The continued growth of the sector brings fresh opportunities and risk.

As patients and providers become better connected and access to health is increased, greater dependency on technology also brings more issues around privacy and security. It is imperative that the necessary precautions are implemented to ensure boundaries between professional and personal do not become so blurred just because they are no longer physically there. &

Jennifer Schoenthal is the lead underwriter and manager of the Beazley Virtual Care product. Kyle Laudadio is an underwriter on Beazley’s Private Enterprise (PE) team where he specializes in miscellaneous medical risks for small to medium-sized enterprises.

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