Disparities From the Pandemic – Impact on Behavioral Health Care

Social determinants of health lead to disparities in healthcare. The COVID-19 pandemic exposed the behavioral health industry’s weaknesses, making it difficult for people suffering the most from the pandemic to get help. We’ll review what social determinants of health are and how the pandemic blocked people from getting behavioral health services.  

What are Social Determinants of Health?  

Social determinants of health make up everyone’s daily environment. They include where people live, their spiritual activity, their age, and other conditions in their surroundings. These aspects affect physical and mental health throughout someone’s lifetime. Here are some examples of social determinants that can impact a person’s health: 

  • Economic stability 
  • Access to quality education 
  • Access to quality healthcare 
  • Neighborhood and built environment 
  • Social and community environment 

Let’s consider how income level can have a significant impact on health status. To eat a healthy diet, a person needs to spend money on nutritious food and reliable transportation, with enough stores nearby stocked with good choices.  

Having more money makes it easier to overcome each of these obstacles, but for a person with a low income, every dollar matters, and the margin for error may be thin. If they can’t afford to fix their car or pay for bus fare, the better grocery store across town may not be an option for a while. Overall food budget may grow and shrink based on other needs.  

Over time, limited food choices could impact this person’s risk for chronic health conditions. The same barriers may make it difficult to use healthcare services and live in safe areas. That’s why understanding the impact of health determinants is essential.  

Informing people about healthy eating is important. But eating well consistently is a different story. A one-size-fits-all message about healthy lifestyles becomes tone deaf unless these social determinants are seriously considered.  

Barriers to Behavioral Health Care – Impact From the Pandemic 

Behavioral healthcare services have been in high demand for years, but the people who need them the most often have trouble getting access. Funding opportunities and innovation have been low priorities for government agencies and insurance companies. Behavioral healthcare faces many long-standing barriers to improvement after several decades like this. With the demand increasing since the pandemic, these barriers are more apparent than ever. 

Shortage of behavioral health providers  

Because of high demand, getting an appointment with a psychiatrist and addiction medicine specialists can be challenging. Since they provide critical services to those with the most severe conditions, this shortage can have grave consequences. The projected growth of these two professions may not be enough to keep up with population increases. Other professionals, like advanced practice nurses and physician’s assistants, could fill this need. 

Impact from the pandemic 

The shortage of behavioral healthcare providers was a problem before the COVID-19 pandemic emerged. As the pandemic developed in early 2020, demand for mental health care increased, but limited access to services became an immediate problem. When offices closed and stopped taking in-person appointments, people couldn’t begin or continue treatment.  

The sudden cut-off of services may have been necessary for pandemic safety reasons. But it created a massive disruption in treatment for people around the world. Clinics that quickly pivoted to telehealth or phone services stayed connected with people. But to save on costs, some offices reduced hours and laid off providers.  

Financial barriers 

Financial barriers can prevent people from getting quality behavioral healthcare. The behavioral healthcare industry has historically lacked adequate funding, and those issues were exposed further by the pandemic. 

Lack of funding for behavioral health programs 

Government funding makes it possible for clinics to offer behavioral healthcare to people with financial needs. When this funding gets cut, people with more challenges in their environment often can’t afford treatment anymore. 

Lower socioeconomic status 

In general, a person with a lower socioeconomic status faces more stressful life situations. They may have trouble affording public transportation or upkeep on a vehicle. These individuals may struggle to put food on the table and pay rent. Paying for healthcare services may not be an option. 

Inadequate healthcare insurance 

People with lower incomes often have jobs without healthcare coverage or their coverage is inadequate and hits them with a lot of out-of-pocket expenses. With more stressful life circumstances, these individuals are vulnerable to more health problems and have a greater need for healthcare services. 

Impact from the pandemic 

The pandemic created an unpredictable future for people with low incomes. Jobs with lower pay are often hourly or part-time positions with no benefits. They also may not require special skills, making it easier for employers to let people go. As in-person businesses closed for weeks at a time, layoffs and reduced hours lead to sleepless nights for many people. Also, testing positive for COVID-19 meant going without a paycheck for several days or weeks.  

Pandemic-related stress led to an increased need for many behavioral health services. The financial barriers listed above all made it more difficult to get help. The very people most likely to need behavioral healthcare often had the hardest time getting it. 

Lack of trust in the healthcare system 

People in vulnerable populations, like ethnic and racial groups, have low trust in the healthcare system. For decades, these individuals endured racism and harmful acts from people who were supposed to care for them. The healthcare industry lacked diversity for many years, making it difficult for diverse populations to relate to providers.  

Many providers still lack the cultural competence to create more trust. Awareness has improved and attitudes have been changing, but it’s not surprising that members of diverse populations are still wary of seeing healthcare professionals. 

Language barriers can lead to miscommunication or avoidance of care. People from diverse populations have more trouble accessing servicesAnd the quality of services they can use is often lower. Overall, these individuals face the worst healthcare disparities in the United States. 

Impact from the pandemic 

Low trust meant that people hesitated to get care during the pandemic. And when they did, it was often delayed or difficult to access. When healthcare providers closed their doors to in-person visits, telehealth services boomed. However, people from diverse populations are less likely to have internet service at home. Without a stable connection, telehealth couldn’t bridge the gap for everyone.  

Social Determinants of Health – Ongoing COVID-19 Impact 

The pandemic may be lessening in strength, but the disparities will likely linger. The behavioral health industry has been strained for years, and the pandemic exposed many existing shortcomings. While this may be a challenging time, it may also reveal opportunities to review priorities and find creative solutions. 

Read more population health articles on the AIHI Blog