Mental health providers can be difficult to find in rural areas, particularly in rural areas. That’s where video calls are filling the void and helping long-term care residents who might otherwise be without mental health services manage anxiety and other issues, according to media reports.

Omaha, NE-based Encounter Telehealth uses approximately 20 mental health professionals, many of whom are psychiatric nurse practitioners living in cities, to help nursing home residents in rural areas.

“The practitioners read the patients’ electronic medical records through a secure computer system, and they review symptoms and medications with nursing home staff members before each appointment. They complete up to 2,000 visits a month,” Kaiser Health News reported. 

Access to mental health and other services was a challenge even before the pandemic. Nursing home residents in rural areas needed to be driven to other towns for services. “That could eat up hours of staff time and add stress to the patients’ lives,” according to KHN.

Substituting healthcare visits with video technology is unlikely to disappear as the pandemic wanes, according to experts. The phenomenon started before the public health emergency and has grown substantially since 2020 on for numerous reasons, including bans on in-person visits and staffing shortages.

“Even as the country emerges from the pandemic, it is highly likely that the use of telehealth in nursing homes and other settings (including the home) will continue, depending on regulatory issues and broadband access,”  Scott Code, vice president of LeadingAge Center for Aging Services Technologies, told the McKnight’s Business Daily.

Accessibility issues

One challenge for remote mental health and other services is broadband accessibility, Code noted.

“As more residents and staff rely on video chat and telehealth services, the demand on broadband infrastructure increases (higher speeds and robust infrastructure). Basic connectivity is not sufficient, as many of our nonprofit, mission-driven members learned during the pandemic,” he said.

Miravida Living, a senior living and skilled nursing provider in Oshkosh, WI, was able boost its broadband by using a private donation from a resident, plus additional grant money from the Oshkosh Area Community Foundation, to raise approximately $15,000 to enable installation of new Wi-Fi access points to the building.

“While rural nursing homes can access broadband through the Rural Health Care Program, for providers in other care settings, such as home- and community-based services (including affordable housing), connectivity is more of an issue in where individuals are on their own to access broadband,” Code said.

That is why LeadingAge supports legislative action aimed at expanding the scope of the 2015 Rural Healthcare Connectivity Act, he said, to include home health, hospice and other aging services providers in the home and community. 

“Such action would allow all aging services providers to take advantage of lower internet connectivity costs offered to acute care and nursing homes,” Code said.

According to Code, LeadingAge CAST supports keeping pandemic-related telehealth flexibilities such as:

  • Permanently removing the geographic restrictions on telehealth;
  • Allowing the home to be an originating site of care beyond the PHE;
  • Permanently expanding the list of provider types that can furnish telehealth services in both physical and mental health;
  • Continued flexibility in the type of modality allowed for video-audio connections (for example, allowing the use of FaceTime or other smartphone technology) to use all tools available, including audio-only, to deliver telehealth services as appropriate and look to work with Congress on the intersection of accessibility and privacy (for example, HIPAA concerns).

Some are reluctant

Even with the increase in telehealth services in recent years, some doctors, nurses and other health providers remain reluctant to use it when dealing with medical issues affecting older adults, according to a national survey of more than 7,000 healthcare providers conducted by the West Health Institute in San Diego.

According to the research, more than 60% of clinicians believe that the use of telehealth is “dangerous” for older adults because of their complex medical needs. Also in the survey, 63% of responding clinicians said they believed that telehealth was unrealistic for many older adults because of their physical or cognitive challenges.