Healthcare News and Trends
COVID-19, Telepsychiatry and the Future of Behavioral Health Jobs
May 17, 2021
By Linda Beattie, contributor
The COVID-19 pandemic has created a tsunami of problems
across the United States, affecting the public’s mental health in addition to
the numerous physical casualties. Fears of the disease, grief for those lost, social
separation and economic hardships have created new cases of anxiety and
depression, while exacerbating existing mental illnesses.
A new poll
by the American Psychiatric Association (APA), conducted
March 26 to April 5, 2021 among a sample of 1,000 adults, found that:
- 41% are more
anxious than last year when the pandemic began
- 43% said the
pandemic has had a serious impact on their mental health (up from 37% in
- 53% of parents are
concerned about the mental state of their children
- 48% of parents reported
the pandemic has caused mental health problems for one or more of their
children, with 26% seeking professional help
During this same period when Americans
have developed a greater need for mental health services, psychiatrists have
had to make drastic cuts to in-person visits and dive into telepsychiatry.
“There is a
huge global shortage of behavioral health physicians, and the market is
unfortunately dictating a greater need. Then with the pandemic shutting down
some services, we saw a major transition to telehealth platforms,” said Gabriel
Bishop, director of recruiting for the diversified specialties group at Merritt
What is telepsychiatry?
The APA defines telepsychiatry as a subset of
telemedicine, which is “the process of providing health care from a distance
through technology, often using videoconferencing.” They add that telepsychiatry
“can involve providing a range of services including psychiatric evaluations,
therapy (individual therapy, group therapy, family therapy), patient education
and medication management.”
usually involves direct psychiatrist and patient interaction, it may also
include psychiatrists supporting primary care providers through professional
consultations. It can be delivered via live, interactive communication or
involve recorded information.
Rumbles of change before COVID
“In the three or four years before COVID hit, psychiatrists had
been asking about telepsychiatry,” said Mike Belkin, divisional vice president
for Merritt Hawkins. “They were interested in doing virtual visits, asking
about working from home, but the market was very slow to respond. Some clients
agreed to allow some of these visits, but most did not. They were worried that patient
care would be sacrificed. Reimbursement was also an issue.”
“Some areas that found recruitment challenging decided to try
it,” he continued. “We had some clients that were starting to incorporate one
to two days of telepsychiatry visits to help attract those candidates who
wanted greater flexibility.”
“Now with the pandemic creating the need for so many virtual visits,
candidates are seeing that they can serve the patient population digitally, but
many clients are still slow to engage.”
The overall demand for psychiatrists has increased during the
pandemic, noted Belkin. “We are receiving a number of requests for
psychiatrists, which reflects the reports of more behavioral health issues during
this crisis. The needs have spanned adult as well as child and adolescent
“But the hospitals and practices requesting child and
adolescent practitioners are generally not looking for telepsychiatry; they are
seeking psychiatrists who are willing to move,” he added. “And the nation’s limited
supply of child and adolescent psychiatrists makes these candidate searches
even more challenging.”
The current state of uncertainty
“So many physicians would love a telepsychiatry position, but
clients continue to worry about patient care, loss of continuity, reimbursements,
etc,” said Belkin.
“With the current state of emergency, televisits are reimbursed
for now, but we’re not sure what is going to happen in the long run. There has
been a lot of lobbying to extend those or make them permanent. But healthcare
clients still have their doubts,” he explained, adding that their hesitancy may
also relate to questions of liability if an adverse outcome occurs following a
“Yet those working in the field are telling us that, in terms
of patient care, it doesn’t seem that patients have less care or worse outcomes.
Our mental health providers report their level of service is just as good,” he
Healthcare employers that have tried telepsychiatry have also
enjoyed some success, Belkin noted, including one of the firm’s clients in
Wisconsin that was having trouble filling a permanent position. Once they
opened it up to telepsychiatry, it took just 45 days to secure a qualified
psychiatrist. Both client and physician have become fans of the arrangement
Questions of access to mental health services
Belkin noted that the convenience of virtual visits and
avoiding crowded waiting rooms has been attractive for many patients.
“One caveat to the telemedicine trend, however, is that some don’t
have good internet connection, or it fades in and out, which can be a problem,”
While telepsychiatry can create greater access for some clients
living in remote areas, public health experts have voiced concerns about
inequities that may leave some unable to receive care in a virtual environment.
“A lot of organizations
are trying to meet the needs of psychiatrists and their clients, but patients
may not have the technology resources to be able to see these professionals
remotely because they don’t have a smartphone or laptop or reliable internet,”
their attraction for psychiatrists, Bishop explained that there are some
limitations to telepsychiatry visits.
language is very important to be able to see when visiting with a patient, and
a psychiatrist or psychologist can’t necessarily see that during telehealth
visit; they may not see what the person is doing with hands, feet, etc.,” she
health conditions are also less conducive to teletherapy.
“If you are
treating depression or anxiety that needs to be addressed, a telehealth visit
can work. But if a patient has schizophrenia, or other more acute cases or
comorbidities, those may need to be seen in person,” said Bishop.
same patient may need different support at different times, she explained. “A
lot of it may be medication management, so that one-month checkup online may
make sense. You can easily do that virtually.”
thing candidates might need to consider is the compensation rate for
clients are open to offering full-time, remote positions but the compensation
is going to be less,” said Bishop. “Telehealth may not be as high paying.”
Psychiatry recruiting impacted by virtual practice and workforce
health clinicians have decided that they can practice virtually from home,
making it more difficult to have people consider a traditional, onsite job,”
reported Bishop. “Going forward, I think more organizations need to be open to
having some flexibility in their work schedules, like three days on site and
two days working remotely--some kind of nontraditional schedule.”
“I can’t think of one candidate who has had a negative
experience practicing in the virtual environment; most would prefer to work
from home, or not have to relocate,” Belkin added. “There are so many opportunities
for behavioral health jobs, but not everyone wants to move.”
“We need to figure out a solution in psychiatry, as the
workforce demographics aren’t promising. More than 80 percent of psychiatrists
are over the age of 45, and 60 percent are 55 or older,” he continued. “Psychiatrists
do practice longer than their medical colleagues, and their average retirement
age is older since they don’t usually encounter physical limitations. But
supply issues are still a challenge.”
A limited capacity to train new practitioners is part of the
issue, according to Belkin, who noted that there are less than 2,000 psychiatry
residency slots each year. Without a robust pipeline of new physicians, the workforce
shortage is expected to become an even larger crisis.
Telemedicine and the future of psychiatry jobs
“We expect the
demand for psychiatrists will continue to climb,” said Bishop. “There could be
a trickle effect for years to come from the pandemic, due to people who
experienced traumatic losses, extended seclusion, situational depression or social
anxiety. It could take years before we know how it affected younger kids especially.”
visits are also expected to remain popular, though the percentage of mental
health services provided remotely vs. in-person will vary depending on
location, compensation and other factors.
“The availability of reimbursement funding will have a huge
impact on whether an organization will start offering telepsychiatry as an
ongoing piece of their business,” said Belkin.
“If candidates are patient, we believe there will be more
dedicated telepsychiatry positions down the line,” he concluded.
of Age During COVID Pandemic
Psychiatrist Charles J. Morgan
Review: How COVID-19 Changed the Market for Physicians
Merritt Hawkins, part of AMN Healthcare’s Leadership
Solutions division, is the nation’s leading permanent placement firm for
psychiatrists and other physicians and advanced practitioners.
Candidates: FIND PSYCHIATRIST
JOBS or CONNECT WITH A
Employers: REVIEW OUR CLIENT
SERVICES or REQUEST A CALL.
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