Living through the COVID-19 pandemic has taken a serious toll on behavioral health. More than three in 10 adults reported symptoms of anxiety or depression since May 2020, up from one in 10 in 2019.

“This has been a serious, psychological, stressful event,” says Dr. Mathieu Bermingham, a psychiatrist and member of the board of directors of the National Alliance on Mental Illness Massachusetts. “Some of us have talked about the tsunami effect on mental health. I don’t think we fully know yet because we’re still in it.”

With so many people experiencing symptoms — many for the first time — conversations about behavioral health struggles and treatment options are growing louder. And more people are listening.

“There’s never been a greater appreciation or recognition of the importance of behavioral health care and seeing it as part of a person’s total medical care,” says Jill Borrelli, LISCW, vice president of behavioral health at Point32Health.

These pandemic-era shifts have ushered in changes to behavioral health care — including care for anxiety, depression, and substance use disorders — that could have long-term impacts. From the near ubiquity of telehealth treatment to the integration of behavioral health into overall wellbeing, it’s unlikely the landscape will ever look the same as it did before the pandemic.

Behavioral health tech creates access and a continuum of care

Once more of a niche service, telehealth for all types of health care has taken hold during the pandemic. Aside from keeping patients and providers safe from COVID-19, Borrelli says, telehealth also boosted behavioral health care access for underserved populations, such as rural residents, who struggled to find local care even before the pandemic.

“It’s a lot easier for people to access behavioral health if they don’t have to find childcare or take time off from work,” she says. “They can do it in their house or wherever feels safe and private.”

Fifty-three-year-old “Anna,” music director for a South Shore church, says receiving virtual therapy for her anxiety and attention deficit hyperactivity disorder (ADHD) has been, in some ways, easier than getting in-person treatment. “For people with ADHD, transitions are really hard,” says Anna, who requested her name not be shared to protect her identity. “Getting myself out the door to a physical appointment is a lot of work.”

Because she changed providers during the pandemic, Anna has never met her current therapist in person. Nevertheless, Anna says she’s happy with the progress she’s made in her virtual sessions. Anna and her therapist have even found a virtual way to use a technique called eye movement desensitization and reprocessing (EMDR), which involves Anna visually tracking an object back and forth while recalling a traumatic memory. “We pull up a little moving EMDR thing on YouTube,” Anna says, “and screen share.”

Apps and digital solutions are also taking a more prominent role in the full continuum of behavioral health needs, from stress management to addiction recovery. For instance, Borrelli says, Point32Health is constantly exploring emerging innovations and new technologies that challenge the traditional substance use disorder (SUD) treatment model, like the company’s collaboration with Spectrum Health Systems on an SUD Center of Innovation, which helps uncover evidence-based solutions to support members throughout recovery.

“Treatment isn’t always just sitting in an office with a therapist. There are lots of ways to care for your own behavioral health,” Borrelli says. “Integrated, whole-person care is really the best way to approach all health care.”

Innovative models of care and payment take hold

Companies like Eleanor Health, an addiction treatment provider, are also reimagining the traditional approach to substance use disorder care. Eleanor Health deploys a team of providers — which could include therapists, coaches, nurses, and medication managers — to connect with patients wherever they are. This could be in a hospital emergency department, a local coffee shop, one of Eleanor Health’s 30 clinics in six states, or online, says co-founder Corbin Petro.

One of the most innovative elements of the Eleanor Health model? The service is provided at no cost to patients. Eleanor Health is reimbursed by insurance companies based on its ability to achieve outcomes, such as improvements in substance craving and patient retention, Petro says. “We believe that we can change how care is delivered and paid for,” she says.

Though COVID-19 infections are dropping and mask mandates are lifting, Borrelli says the increased need for behavioral health care isn’t likely to dissipate. “Anyone who has ever experienced a mental health issue … knows that the moment a trigger goes away does not mean that you instantly return to your previous state. The behavioral health impact of disasters really outlasts the physical impact.”

Teletherapy is likely to remain available as the pandemic wanes, Bermingham says, but many therapists and their patients prefer a hybrid approach that includes occasional in-person meetings. We can also expect to see behavioral health integrated into a greater variety of settings, such as primary care offices and schools.

“There’s no health care without mental health care,” Bermingham says. “If this pandemic creates in the system a willingness to listen to the people who experience this the most, then it will have opened up something really wonderful for the development of the field.”

Harvard Pilgrim Health Care and Tufts Health Plan, as part of Point32Health’s family of companies, are committed to enhancing access to equitable care — physical and mental — for all their members, and for communities throughout New England. Learn more about Point32Health.