Navigating Continuing Care

The pandemic that has occurred over the course of this year has altered the healthcare system as whole in more ways than one. The impact of these alterations may be short term, indefinite, or permanent- as the unknowns of what is, what is to come, and what will be, leave many with a feeling of unease. The unease and ambiguity of the unknown has certainly created and/or exacerbated mental health struggles in individuals, and I have specifically observed this amongst the young adult population that I have worked with in the setting of an acute psychiatric unit.

Young adults come to us to seek care for their mental health struggles when they are at their most vulnerable and acute state. These individuals are getting the most individualized support and assistance with their struggles from our team at Malvern who wholeheartedly care about bettering their lives and focusing on the psycho-social stressors that are causing these individuals to escalate into a crisis. Our team becomes the beginning of the individual’s road to recovery, and our impression can significantly impact their relationship and motivation to furthering their mental health care both in the present and future.  As we are either start or fresh start of the path to recovery, we emphasize the importance of continuing long-term treatment, and this is crucial for enduring real change.

In my observations, the world of tele-health has brought many positives and negatives to health care. I have seen some individuals reach their most acute state and come to us to seek treatment because their tele-health on the outpatient and community level was ineffective for them to sustain and maintain. Some individuals have expressed concern in regard to not having access to internet to participate in treatment, some do not like seeing themselves through the lens of a video camera, some have found it difficult to engage with others through the tele-mode, and some have expressed tele-health to be a barrier with internet service going “ in and out” and “ cutting out”. Also, some have expressed difficulty becoming motivated to call or video conference a provider. Confidentiality has also been a concern expressed because some of these young adults have family, friends, or roommates that could possibly hear their therapeutic sessions from being in the same living environment.

On the flip side tele-health has caused many to seek treatment that may have not otherwise have done so.  Tele-health has been a factor in regard to transportation no longer being a barrier to treatment, as treatment can be provided in the comfort of one’s own home. Tele-health has made it so there is greater access in regard to resources and has enabled clinicians from the inpatient level to set the patient up with a more individualized provider, one that will fit their needs no matter where the provider or facility may be located. Schedule conflicts regarding areas such as work are now less of a barrier, as providers now have some more flexibility with times that therapeutic sessions are being held.

As facilities and providers are slowly but surely opening up to “in person” treatment forums while practicing social distancing; this has opened the door for individuals seeking treatment to have options. Options have created these young adults we treat to have more of a sense of empowerment. They can now choose which forum of treatment is more beneficial: in-person or tele -health? Regardless of the forum treatment is provided, it is ingrained in the individuals we serve to just seek help. No matter what. If there are barriers to seeking help this must be communicated and discussed while our patients are with us. We encourage our patients and their support systems to collaborate with our team and work through these barriers, as well as outline solutions to the barriers prior to discharging from our inpatient facility. If barriers are not identified and worked through, then the odds are that nothing is likely to change and cyclic patterns and habits that are not healthy are more likely to continue. Our mental health team of professionals promote change and encourage our patients to look at what is going on for them from different angles and perspectives- “digging deep” is essential. We empower our patients to create their own change within themselves. Setting our patients up with services and resources in the community is the first step to improving their well-being in a long-term manner.