- Shandra Brown Levey, PhD, Director of Behavioral Health and Integrated Programs, University of Colorado School of Medicine, Dept. of Family Medicine, Aurora, CO
- Jacqueline Calderone, MD, Assistant Professor, Department of Psychiatry & Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO|Bethany M. Kwan Associate Professor, Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO|Lauren Tolle, PhD, Assistant Professor, Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
- Aimee Zisner, PhD, LP, Senior Instructor, University of Colorado School of Medicine, Aurora, CO
The COVID-19 pandemic has significantly altered daily life for most individuals. Its impact on mental health has been substantial, with increased isolation, an exacerbation of existing mental health concerns, including substance use, depression and anxiety. It has led to medical professional burnout and taxing on the healthcare system, grief, and loss (loss of job or financial stability/housing/normalcy/in person school/social activities) as well as concerns for an increase in suicidality, domestic violence and abuse. The COVID-19 pandemic has also impacted how integrated behavioral health or PCBH models of care are occurring. With the rapid expansion of telehealth services, and many during the initial months of the pandemic practicing exclusively remotely, team-based care shifted from sharing space, hallway discussions, and in-person warm hand-offs to virtual attempts to replicate this integration. The University of Colorado has a robust history of PCBH. Now, with 1 year into the pandemic, we have an opportunity to reflect on how we have risen to the challenge of meeting patient demands in a virtual and hybrid in person/virtual capacity, and what we have observed in terms of the shifting needs of individuals, the acceptability of telehealth for behavioral health services, and the access this has offered to underserved and marginalized populations. A program evaluation comparing how this work has shifted in the last year as compared to the year prior has yielded some interesting although perhaps not surprising findings. Primary care has seen a 313% increase in anxiety as primary presenting concern, a 290% increase for depression, a 458% increase in PTSD and a 477% increase in alcohol related disorders. The number of patients served between mid-March 2019-mid-March 2020 as compared to mid-March 2020-mid-March 2021 has increased by 574 individuals. Patients served in primary care with a behavioral health episode of care increased by 45%, from 1,238 in 2019-2020 to 1,802 in 2020-2021. The population served in the expanded integrated telehealth space has also grown more diverse, with a 366% increase in patients who identify as Hispanic, 437% increase in patients who identify as Black, and a 655% increase in patients who identify as Asian between the two years, reflecting a potential increase in access to behavioral health services with the expansion of telehealth. Implications for health care policy and health equity will be discussed.
- Identify how the University of Colorado has transitioned to manage population needs during the Covid-19 pandemic.
- Discuss how the pandemic and the availability of telehealth has impacted minority and underserved populations in terms of accessing care.
- Describe additional ways in which the transition to telehealth services has impacted team-based care.