Few would argue that 2020 was a turning point in many ways. The COVID-19 pandemic, social and economic inequalities, racial balancing and environmental disasters collided and merged into a reality shaped by enormous challenges that were barely foreseeable. This combination of factors has created an increasing need for counseling and psychiatric care.
The dramatic increase in the number of people reporting mental disorders has attracted national attention and increased social recognition of the relationship between mental and physical health. As a result, mental health and well-being, or lack thereof, has acquired a new urgency and can no longer be ignored.
Our recent work as a mental health advisor in an emergency care setting or as a professional advisor and educator has given us a unique firsthand perspective on this valuable opportunity. We believe the Emergency / Emergency Facility offers a promising new framework for the delivery of mental health care. A number of emergency facilities have already incorporated mental health services into their practice with positive results. Mental health providers have become integral parts of integrated and interdisciplinary teams. Hence, the main aim of this article is to promote and highlight the integration of collaborative mental health resources into these nursing clinics.
Psychiatric and emergency care
A trip on most urban thoroughfares, suburban boulevards or even rural city streets often leads to a sighting of an emergency / immediate supply facility or at least a display for such a facility. The proliferation of these clinics in recent decades has led to their ubiquitous presence in the community and in the healthcare sector.
The dramatic increase in mental health problems across the population, exacerbated by the COVID-19 pandemic, requires a strategy of containment. An effective intervention that has also seen rapid growth recently is the inclusion of psychiatric care in the urgent / immediate clinic. There were positives and negatives in both the results and the results, which inspired us to examine the pros and cons of this burgeoning concept.
History
The concept of emergency care for barrier-free health care emerged in the 1970s. Initially, these clinics were manned by doctors who provided basic care for minor problems such as colds and sore throats and minor accidents that required first aid. Over the years the number of immediate / emergency facilities has increased and the range of treatments has expanded.
Increased treatment options, expanded availability, timely care, and affordability are some of the reasons why an estimated 3 million patients visit emergency centers weekly. Their convenience, accessibility, and the omnibus approach to treating various medical problems, including the purchase of a family doctor, make them an attractive alternative to the bureaucratic and often alienating nature of the traditional healthcare industry. The COVID-19 pandemic has also exposed various weaknesses and injustices within our traditional health care system and has positioned the emergency / immediate care industry as an integral part of a comprehensive plan to prevent and contain such crises.
Mental health problems
Urgent Care, COVID-19 and Aftermath
The vital role of the emergency / immediate care facility was confirmed during the pandemic. These facilities have functioned effectively as testing centers, providing quick tests and results to the public. They enabled access to health care providers as the pandemic strained and overwhelmed traditional access to health care.
With the growing relationship between mental health care and emergency care, the provision of mental health services appears to be an essential and effective strategy for the increasing prevalence of mental health symptoms. The COVID-19 pandemic is leaving a trail of lasting effects, including economic and psychological effects that are not yet fully understood.
While the physical risks and symptoms of the pandemic will improve with vaccines and increased knowledge of the virus, mental health problems may persist as people struggle with serious problems that can become chronic or episodic. Since reactions to the pandemic and the accompanying stressful environment intensify the negative symptoms, an overall benefit may be the increased exposure to mental health problems.
Growth in delivery systems
Other trends primarily driven by the pandemic include an exponential increase in the use of elementary health options. This includes various mental health providers who choose to use these delivery platforms with their clients and customers seeking mental health services from online consulting firms.
On-line counseling service companies typically offer subscription plans and packages, and match customers with a qualified provider. These companies have seen strong growth recently, with the appeal that all aspects of care can be delivered through an online platform. These aspects can include the use of insurance, admissions interviews, therapy sessions and the possibility of making an appointment.
Traditionalists and critics argue that an essential element of the counseling relationship and the counseling process is lost in the telemental health format. In addition, most insurance companies have not accepted or reimbursed these efforts. The disadvantages of online counseling include the loss of intimacy in the personal counseling relationship, the lack of insurance cover, unreliable technology, the difficulty of treating severe mental disorders, and the general lack of non-verbal communication.
Advantages
Omnibus service and availability: Emergency / immediate supply facilities currently have a large capacity and are being expanded in all parts of the country. The additional provision of mental health services in these existing and future facilities would expand exposure and treatment (proactive, reactive, and crisis) to reduce the prevalence of mental health disorders – disorders that cost billions in financial terms in spending and lost work.
This omnibus approach is conducive to “one-stop shopping”. Many mental disorders first show up as physical symptoms. In this way, these can be treated by the health care provider, who can then refer the patient / client to the house to assess their mental health. This would prevent long delays in accessing services instead of referring patients to outside psychologists who may have long waiting lists or not admitting new patients. The amalgamation of mental and physical health services in one facility would create comprehensive continuity of care.
COVID-19 Implications: The pandemic has increased the prevalence of mental health needs in all population groups. Like the COVID-19 vaccine distribution challenges, the distribution of mental health services is also a challenge. Use of the existing care system and structure of the emergency / immediate care industry could significantly expand and strengthen the existing psychiatric services that can be offered or made available to those in need.
Professional practitioner: Access to professional psychologists, especially psychiatrists, has reached a stage of crisis. The number of new doctors choosing psychiatry has declined over the decades, while the number of retiring psychiatrists has increased. Rural access to mental health care is extremely limited or unavailable, and urban access is restricted by long waiting times and “no new patient” policies. These factors are not conducive to the successful treatment of mental illnesses.
Healthcare professionals available in emergency / emergency facilities can work with experienced licensed professional counselors / therapists who are trained and experienced in mental health management to assess, diagnose and through medication, or psychotherapy successfully treat a combination of both.
Loneliness: AARP has warned that the coronavirus pandemic is also causing a loneliness epidemic which, with the aging population, adds up to nearly $ 7 billion a year in the cost of Medicare. Loneliness also contributes to other medical conditions that make people more prone to Alzheimer's, high blood pressure, suicide, and even the common cold. Some researchers suggest that loneliness is more dangerous to people than obesity and smoking. Like mental health, loneliness carries a stigma that hinders aid.
The simple presence of another person with whom one can talk, testify or make contacts leads to more positive results. One of the most effective methods of improving loneliness is cognitive behavioral therapy (CBT), which helps individuals examine their thoughts, perceptions, and assumptions and how they affect behaviors – including behaviors that can lead to loneliness. Improved access to mental health providers in affordable, accessible, and convenient urgent / immediate care facilities can help mitigate the negative effects of loneliness and other social isolation diseases that are increasing as a result of the pandemic environment.
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A photo of the front of the City MD Urgent Care building in Brooklyn, New York.
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Conclusion
The parity of behavioral / mental and physical health services has long been an issue. The Affordable Care Act addressed many of these issues by enacting laws calling for equal mental and physical health coverage, but there is room for improvement.
The National Center for Health Statistics reported in 2018 that suicide was the 10th leading cause of death in the United States for all ages. In 2016, suicide became the second leading cause of death between ages 10 and 34 and the fourth leading cause of death between ages 35 and 54. Immediate access to mental health care is critical to reducing this rate and many other mental health diagnoses.
The immediate / urgency system can be a strong partner in dealing with these social concerns in coordination with psychiatry and their professional providers. Consultants should take a leadership role in advocating change, especially in these delivery systems. Appeals to local governments, insurance companies, and counselor training programs can make it more accessible for all segments of the population. Mental health professionals can encourage emergency clinics to create mental health posts in their groups, as many clinics have more than one location.
It is important that we highlight the potential of a seamless omnibus approach of a single comprehensive visit or site to address any health need or issue. Ultimately, a marriage between emergency and immediate care clinics and psychosocial counselors can improve the accessibility and quality of care and reduce challenges and obstacles.
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James "Todd" McGahey is a Licensed Professional Advisor, State Certified Advisor, and Associate Professor of Advisor Education at Jacksonville State University. He also serves as a mental health advisor and provider for Beach Family Urgent Care in South Carolina. Contact him at [email protected].
Melanie Drake Wallace a Licensed Professional Advisor and State Certified Advisor, is Professor and Head of Counseling and Educational Support at Jacksonville State University. She also serves on the Governing Council of the American Counseling Association. Contact her at [email protected].
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Opinions and statements in articles appearing on CT Online should not be construed as the opinions of the editors or guidelines of the American Counseling Association.