For stressed health care workers, a mental health oasis awaits on their computer or phone — they log into a virtual space and see large windows with expansive nature views, calming music, a caring therapist, and other people just like them — but through a filter of anonymity.
This is the virtual mental health care experience offered by Cabana, a product of Annapolis-headquartered Even Health. The platform is offered to health care workers from multiple health systems through their employers to deliver professionally moderated group support in a virtual reality based environment.
It’s just one of many technological solutions that have been launched as more and more insurance companies, health care clinicians, and health systems look for innovative practices. Maryland is home to many of the leaders in this field, including Even Health, Bloominmind in Columbia, Mindoula in Silver Spring, and Rose Health in Baltimore.
The industry is reporting an increase in demand and interest for these solutions, even as behavioral health care settles back into in-person and new hybrid methods of care.
Steve Sidel, founder and CEO of Mindoula, said that at one point during the COVID-19 crisis even the company’s service line that provides behavioral health services for inpatient psychiatry wards was using exclusive virtual therapy and video conferencing on tablets.
Now, even as patients become more comfortable with in-person visits, some of the video conferencing appointments have remained.
“You’re seeing the pendulum swing back, you’re seeing less utilization in behavioral health of purely virtual solutions and more utilization of hybrid solutions,” Sidel said.
Clinically, the outcomes for virtual therapy are very similar, at times indistinguishable, from in-person therapy, he said. And it allows mental health practitioners more options and flexibility in how they practice, potentially providing a solution for long-standing problems like critical shortages of psychiatrists in rural, remote areas.
For Kristine Hoestermann, the head of mental wellness at Even Health and a licensed social worker, the burnout during the pandemic was only too real. She was working for health care providers and putting in 10-14 hours per day providing virtual private therapy to clients back-to-back. It took a tremendous emotional toll, and the telehealth structure would lead to therapists burning out, she feared.
When the opportunity came up at Even Health, Hoestermann realized that clients could benefit from different virtual solutions like Cabana, where she facilitates groups.
“If it (the pandemic) has taught us anything it has taught us we are incredibly creative as humans,” Hoestermann said. “It challenged me to be a better provider.”
The National Alliance on Mental Illness last year published a survey that found more people — 84% — reporting stigma as a major barrier to people accessing treatment for mood disorders. By comparison, a similarr survey conducted in 2009 found 72% agreeing stigma is a major barrier for people seeking treatment for depression).
The latest figure is a number that Even Health CEO and co-founder David Black has taken to heart, saying that with all the anonymity technology can offer, the number should be going down, not up.
On average, a national survey found it takes 11 years for someone to seek support from when they first experience mental health concerns, usually because they believe that their symptoms aren’t that severe, he said.
“We have to focus on not just improving mental health access but in addressing the barriers that keep people from taking that first step,” Black said. “Cost, stigma, trust, and convenience are practical barriers that need innovation – and it’s why we’re looking to expand social support as a means of helping individuals engage earlier.”
Even Health’s Cabana space was designed deliberately by environmental psychologists and a mental health nurse practitioner to connect individuals who share commonalities but may never have found each other, in a space that taps into the healing power of nature and creates psychological safety.
“The opportunity that digital health offers isn’t just to put a camera on traditional therapy, it’s to tailor the environmental settings in ways that accelerate meaningful conversation,” Black said.
Many technological solutions go far beyond traditional clinical delivery. At Mindoula, many of their solutions are care extension services like peer support, case management or collaborative care through primary care physician practices.
Mindoula CEO Sidel said one area that spiked during the pandemic was demand for programs that support victims of violence and adolescents and young adults at critical risk of suicide. With a larger demand, virtual care extenders delivered by Mindoula in partnership with health plans were widely used.
“We were able to save lives in a very meaningful way and help families,” Sidel said. “And what that ended up then doing was helping to let the market know solutions like that from Mindoula exist, and that helped drive demand for those programs even as COVID has receded.”