This op-ed was originally published in the Deseret News by Ana Carrasco, an intern at Libertas Institute.
The Beehive State has a longstanding problem with mental health. In 2019, Utah ranked sixth highest in the nation for its age-adjusted suicide rate, and it is currently the leading cause of death for Utah teenagers.
This year, 1 in 5 Utahns will experience their own struggle with mental illness due to Utah’s mental health professional shortage, the rapidly growing state population, and the increasing demand for mental health services.
Luckily, there is hope.
Telemedicine provides a platform to address Utah’s pervasive healthcare system shortcomings of access, cost and quality. Similarly, telehealth has unique advantages, including healthcare professionals’ enhanced workforce capacity, a more diverse and efficient combination of different labor types, innovation, lower costs, mental health care services disparities’ mitigation, and the prevention of future hospitalizations and general disruptions to daily living.
The COVID-19 pandemic fueled rapid regulatory and legislative changes broadening Utahns’ access to a vast telemedicine services range. Such policy changes, specifically, included temporarily waiving occupational licensing requirements and regulations that would’ve blocked access to large scale telehealth services.
Essentially, the pandemic served as a testing site for telemedicine and its effectiveness.
What we learn from this process is that 80% of mental health providers utilizing telehealth agree that telemedicine is effective in improving patient outcomes. Additionally, 68% of providers stated that telehealth increases client satisfaction, engagement, and retention. Findings like the ones mentioned above coming out of the pandemic illustrate the potential for a sustainable, accessible and affordable healthcare system when government regulation is minimal.
Many Utahns desire to have such an option available. While their mental health needs should be a priority, Utah’s scope of practice laws applying to mental health professionals create artificial barriers that impede effective treatment.
Scope of practice laws are regulations put into place by Utah’s lawmakers that dictate what activities various professionals are allowed to perform. For example, Utah’s scope of practice laws do not allow psychologists to prescribe medications that could reduce waitlists for mental health treatment or prevent families from traveling long distances to see a provider that can prescribe.
The implementation of scope of practice laws are often justified as an ode to increase public health and safety. Although state legislators and policymakers are rightly concerned with patient health and safety, there is no evidence that patients in states with more restrictive scope of practice laws experience better mental health outcomes than in states with less constraining regulations.
Moreover, these well-intentioned directives produce a range of questionable effects. The consequences of present scope of practice restrictions include workforce shortages, decreased access to care, poor health outcomes and increased cost. One should question whether current restrictions are the best practices to safely and effectively address Utah’s mental health crisis, especially when research shows that removing barriers safely and efficiently creates greater access to health care.
Utah’s leaders have recognized the importance of learning from pandemic-related changes to advance regulatory policies that improve Utah’s mental health system. In this sense, they have recognized telehealth’s positive contributions and have advanced initiatives to increase its use.
For example, Gov. Spencer Cox’s One Utah Roadmap has pushed for action-oriented recommendations, including hiring and training more community health workers and expanding telehealth focusing on mental health and substance abuse.
Similarly, in 2020, Utah passed Senate Bill SB161 which requires insurance coverage for mental health and substance use disorders telemedicine services.
While these efforts have been paramount to addressing Utah’s mental health care conspicuous gaps, policymakers have placed little attention on whether qualified mental health professionals can practice to the full extent of their capabilities using telemedicine once the COVID-19 waivers expire.
As health care costs continue to outpace inflation and mental health issues rise, the urgency to remove barriers to telehealth is imperative. Against the present situation, Utah should expand scope of practice to include telemedicine and codify it to enhance workforce capacity and deliver quality care to all Utahns.