Since the COVID-19 pandemic, there has been a significant increase in the number of individuals seeking behavioral health services.

The increase in demand has put pressure on both payers and providers. Over the last few years, several payers have cited the rise in demand for behavioral health services as a pressure on their bottom line. From a financial perspective, traditional therapy for all health plan members is not sustainable. 

“If we went to the Freud model, therapist and patient and everyone got access, your premiums would be 3 times higher on your medical insurance, because it just is not a model that can be sustained,” Rhonda Robinson Beale, senior vice president and deputy chief medical officer of mental health services at UnitedHealth Group, said at The Future of Mental Health. 

Still, many of those seeking care may not need traditional one-on-one therapy. Beale said that over 60% of people who are accessing mental health services are looking for subclinical care and do not need a course of eight to twelve therapy sessions.

Now, some payers and providers are thinking beyond the traditional in-person, one-on-one therapy model.

“[Traditional therapy] can’t work to be the sole supplier of services and behavioral health; you need to have alternatives,” Beale said. “So I talked about peers, community resources, schools, YMCA, even other support groups that have been out there for years, like the Mankind project.”

In addition to community resources, more people could access services at a lower cost through telehealth. Gregory Harris, senior medical director of mental health at Blue Cross Blue Shield Massachusetts, said that he sees telehealth as almost the default for care today.

“It increases access and the likelihood that somebody can get a visit, today, tomorrow, the next day, compared to going into the office, where I think you can take longer and be more logistically complicated,” Harris said.

Digital services can also be used for wrap-around services, such as breathing techniques. But if these services are being used to support therapy, clinicians need to be trained in integrating these measures, according to Beale. 

And for the patient, it can be challenging to determine whether they require in-person care, telehealth or community support. 

Care navigation is a crucial part of finding the right care for the right patient. Harris noted that his organization is investing in both digital navigators and case managers to help direct the patient to the appropriate level of care. Currently, the navigation services focus on three groups: traditional therapy and medications, specialty care and a collaborative care model.

“​​It allows [members] to really navigate online,” Harris said. “These groups are [designed] for ease of access, longevity, making sure that the person stays in care that needs care and doing measurement and working with us to improve measurement outcome.”