Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day twenty nine
Speaker 1: since coronavirus was declared a global pandemic. Our main story.
Speaker 1: The effects of the outbreak are putting unprecedented stress on
Speaker 1: thousands of people. But the difficulty of obtaining mental health
Speaker 1: services while under lockdown and the spike in demand for
Speaker 1: those services threatens to break a treatment network that was
Speaker 1: already strained to the breaking point. But first, here's what
Speaker 1: happened today. Anthony Fauci, the top infectious disease expert in
Speaker 1: the US, says we might see a turn around after
Speaker 1: this week in the fight against the coronavirus. Fauci says
Speaker 1: that now is not the time to ease up on
Speaker 1: social distancing to stop the spread of the virus. The
Speaker 1: Trump administration is discussing how to reopen the economy, but
Speaker 1: specifics haven't emerged. Global officials agree it's too soon to
Speaker 1: lift widespread lockdowns. In a briefing today, Hans Kluge, the
Speaker 1: World Health Organization's Regional director for Europe, said despite progress
Speaker 1: in some places, spikes and cases in Sweden and Turkey
Speaker 1: are concerning knowledge of COVID nineteen and some positive signs
Speaker 1: from some countries do not yet represent victory. They offer
Speaker 1: a rare chance for us to tighten old grip on
Speaker 1: the virus. Now it's not the time to relax measures.
Speaker 1: It is the time to once again double and triple
Speaker 1: or collective efforts to drive towards suppression with the whole
Speaker 1: support of the society. Much needed ventilators are still in
Speaker 1: short supply in many US states, and the federal government
Speaker 1: is unevenly supplying them with what they need. Louisiana, for example,
Speaker 1: has received only five percent of the ventilators it requested
Speaker 1: from the national stockpile. Other states also report that they're
Speaker 1: getting far less than what they need. Even as President
Speaker 1: Donald Trump boasted of great coordination between state and federal
Speaker 1: governments during a Tuesday night news conference, governors say they're
Speaker 1: still facing shortages and delays. Now for today's main story.
Speaker 1: This pandemic has dealt a blow to more than just
Speaker 1: our physical health. Job losses, The threat of sickness and
Speaker 1: indefinite lockdowns have taken a toll on the public's mental
Speaker 1: health as well. When people go through a major disruption
Speaker 1: or loss, symptoms can emerge like anxiety, chess tightness, helplessness
Speaker 1: and disord orientation. Mental health professionals have a term for this,
Speaker 1: it's called adjustment disorder. But just as mental health care
Speaker 1: becomes more necessary, physical distancing and business closures have made
Speaker 1: it harder to obtain. Finding a therapist or checking into
Speaker 1: rehab has become more challenging, And as more consumers look
Speaker 1: for mental health services, companies trying to meet that demand
Speaker 1: need to clear a host of regulatory hurdles. Cynthia Coons
Speaker 1: is a senior reporter at Bloomberg. She recently wrote about
Speaker 1: how a strained system was already failing to meet the
Speaker 1: needs of a lot of people who need treatment for
Speaker 1: mental health. This crisis could make that much worse, but
Speaker 1: it could also open up new avenues to treatment that
Speaker 1: could end up making the system better. I talked to
Speaker 1: Cynthia recently. Before this pandemic even began, would you say
Speaker 1: America was already in a mental health crisis. I spent
Speaker 1: much of the last year writing about mental health in
Speaker 1: America because of issues that had sort of come to
Speaker 1: light about. We have rising suicide rates in the US,
Speaker 1: we have increasing addiction problems, and so we spent a
Speaker 1: lot of time looking into the reasons behind this, and
Speaker 1: we looked into some of the failures of the pharmaceutical
Speaker 1: industry to innovating new drugs, although that is starting to change.
Speaker 1: Some issues around ensures not necessarily reimbursing or covering much
Speaker 1: mental health care in network, and that's a chronic problem
Speaker 1: that prevents a lot of people from being able to
Speaker 1: afford care, and issues of literally not being a ton
Speaker 1: of supply and the mental health sort of world at
Speaker 1: large when you think about things like mental hospitals having
Speaker 1: closed in recent years. So there are a lot of
Speaker 1: reasons to believe that we're not in good shape from
Speaker 1: a mental health perspective just to begin with. And that's
Speaker 1: even before something like COVID comes along and gives us
Speaker 1: all a new form of anxiety to deal with. So
Speaker 1: many Americans right now are under stay at home orders,
Speaker 1: and in particular, what challenges do they pose for someone
Speaker 1: who needs access to mental health care. So there's a
Speaker 1: couple of different layers of this. So there's the basic
Speaker 1: person who might have therapy needs that they would normally
Speaker 1: go visit their therapist in person, and a lot of
Speaker 1: that is shifted to telehealth really quite quickly, and that's
Speaker 1: been remarkable. So there's a company's like talk Space. They've
Speaker 1: seen a six increase in demand since COVID quarantines took place.
Speaker 1: The government said that they're relaxing the HIPPA rules, or
Speaker 1: they're basically relaxing enforcement around HIPPA rules. So now people
Speaker 1: can use FaceTime, which they might already have on their
Speaker 1: phone or Skype, in order to see their therapists. That's
Speaker 1: really a big change. And a lot of insurers have
Speaker 1: moved to make telehealth available or add tell health services
Speaker 1: or make them free. So those benefits have been great
Speaker 1: for people who might need regular talk therapy kind of maintenance.
Speaker 1: But there's another level of people who are really vulnerable
Speaker 1: here getting into rehab, in patient rehab while they're open.
Speaker 1: They're all it takes is one COVID case to change
Speaker 1: the dynamics of whether a rehab is open or a
Speaker 1: psych ward in a hospital. And what about services that
Speaker 1: have to be in person that can't be done via
Speaker 1: telehealth or done remotely. What happens if an issue requires
Speaker 1: say hospitalization. Yeah, that's a big problem here because there
Speaker 1: are rehabs open, there are mental health wards open, there
Speaker 1: are mental hospitals open. But I've talked to a number
Speaker 1: of providers in those settings who have said, were they
Speaker 1: to have one case of COVID, they're probably going to
Speaker 1: have to stop admitting new patients or they have to
Speaker 1: isolate people. And then there's the sheer fact that people
Speaker 1: in those settings can't do some of the group therapy,
Speaker 1: which is quite effective for certain conditions. But hopefully as
Speaker 1: the medical system sort of writes itself and the case
Speaker 1: of COVID patients goes down, and mental health care can
Speaker 1: resume as it had been previously. But it was already
Speaker 1: a system that was slightly tenuously operating, and things like
Speaker 1: detox some of these mental health conditions were handled by
Speaker 1: the e R, and that's going to be a problem.
Speaker 1: Are we looking at perhaps maybe what you might call
Speaker 1: a resource crunch in terms of mental health? You know,
Speaker 1: with even telehealth and these digital platforms, are there enough
Speaker 1: therapists or or mental health providers to go around to
Speaker 1: meet all these new demands for even digital therapies. Well,
Speaker 1: if we left the state licensing system as it was,
Speaker 1: probably the answer to your question would be we would
Speaker 1: be in a very serious um supply shortage. But a
Speaker 1: lot of states have moved to make it much quicker
Speaker 1: and easier for people to use their license in another state.
Speaker 1: So where it used to be, if you're a provider
Speaker 1: in Nebraska, you could only see patients in Nebraska. That's
Speaker 1: what you're licensing dictated. Now, other states that are have
Speaker 1: high demand for therapy and for services are allowing therapists
Speaker 1: and doctors and providers to get rapid access to get
Speaker 1: their licensing approved in that state. So that's really meaningful.
Speaker 1: It's great that the states are moving to rapidly imp
Speaker 1: meant changes so providers can work in other states. But
Speaker 1: it's still going to be a little bit of time
Speaker 1: before we're really up and running. From a very meaningful
Speaker 1: point of view, just because of the sheer nature of
Speaker 1: the fact that it's really complex system, it sounds like
Speaker 1: there is loosening, there's flexibility that we're seeing from the regulation,
Speaker 1: the licensing side of things. I mean, are you also
Speaker 1: seeing this from the, say, insurance side of things. Are
Speaker 1: they taking specific actions to try and essentially just make
Speaker 1: things easier, make life easier in this circumstance. Yeah, number
Speaker 1: that was really encouraging. A number of insurers have said
Speaker 1: that they would actually not even require co pais at
Speaker 1: this time for behavioral health. Behavioral health is the umbrella
Speaker 1: for mental health and um substance abuse and addiction treatment,
Speaker 1: and things like eating disorders or autism spectrum therapy. So
Speaker 1: a lot of insurers have actually said we're we're waving
Speaker 1: copais right now, or they're adding telehealth mental health services
Speaker 1: that they did not have before, and they're adding it
Speaker 1: with either no co pay or regular copay so pople
Speaker 1: can afford it. One of the biggest problems with mental
Speaker 1: health in America getting treatment was finding in network care.
Speaker 1: So the infrastructure under mental health has been pretty shaky,
Speaker 1: and that's why so many people are seeking out of
Speaker 1: network care on a normal day now. Because the insurers
Speaker 1: recognized this surge in COVID, a lot of people are
Speaker 1: seeking help now that might not be traditionally. They're really
Speaker 1: rising to the occasion here and trying to make a
Speaker 1: lot of care virtual care free and accessible. So the
Speaker 1: question is really is this going to work? Are people? Really?
Speaker 1: Is everyone who's seeking it or everyone who's seeking it
Speaker 1: going to be able to get what they need. But
Speaker 1: it's pretty remarkable step for an industry that has come
Speaker 1: under fire for not necessarily adequately reimbursing for mental health
Speaker 1: care for years now. It may be premature to try
Speaker 1: and make these forecasts past the point that we're no
Speaker 1: longer under stay at home orders or something like that.
Speaker 1: But do you potentially think these changes were currently seeing
Speaker 1: will have a more long term lasting effect on America's
Speaker 1: mental health care system, say, after the endemic. That's a
Speaker 1: million dollar question. I think that's what a lot of
Speaker 1: advocates in the mental health community and world would love
Speaker 1: to see. It's hard to say because so much is
Speaker 1: going to change after this pandemic, but I think, you know,
Speaker 1: one of the other benefits that I think we'll see
Speaker 1: from this, our employers are also rolling out services for
Speaker 1: employees and free services or services that are they may
Speaker 1: not have had before, and so hopefully they don't roll
Speaker 1: back those services as soon as the coronavirus fades. So
Speaker 1: longer term, I don't I don't see a rollback to
Speaker 1: the way things were necessarily, but I think we just
Speaker 1: need to see how the health care system kind of
Speaker 1: is reshaped by what's happened here in the last couple
Speaker 1: of weeks and months and however long this goes on for.
Speaker 1: And and that was Cynthia Coons whose article on the
Speaker 1: deepening mental health crisis in America was published last week
Speaker 1: on Bloomberg dot com. And that's it for the Prognosis
Speaker 1: Daily Edition. For more on the pandemic from our bureaus
Speaker 1: around the world, visit Bloomberg dot com slash coronavirus and
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Speaker 1: The Prognosis Daily Edition is hosted by me Laura Carlson.
Speaker 1: The show is produced by Me topher Foreheaz, Jordan Gospore,
Speaker 1: and Magnus Hendrickson. Additional reporting by Cynthia Coons. Original music
Speaker 1: by Leo Sitdrin. Our editors are Francesca Levi and Rick Shine.
Speaker 1: Francesca Levi is Bloomberg's head of Podcasts. Thanks for listening.