Since the beginning of the COVID-19 pandemic, skilled-nursing facilities have focused – rightly so – almost entirely on infection control and maintaining the health and safety of residents and staff. These facilities acted quickly to restrict visitor access and limit resident activities.

With these actions, however, came increased loneliness, depression and isolation for elderly residents. As a result, skilled nursing facilities and other long-term care facilities need to prioritize access to behavioral health services. If mental health is left on the back burner, these facilities will be facing another pandemic after COVID-19. 

Even prior to COVID-19, 22 to 42% of long-term care residents experienced loneliness; in fact, one study found that more than half of nursing home residents without cognitive impairment reported feeling lonely.

Circumstances have undoubtedly worsened over the past several months, and in speaking with long-term care residents it is evident that their biggest fear is loneliness, even more so than this virus. Completely isolated for upwards of nine months, the nation’s elderly population is facing an epidemic of its own: mental health challenges that were only heightened by the holiday season.

Skilled nursing facility residents have had difficulty coping with their mental health challenges – as their means to cope, such as family visits, community activities and human interaction, in general –  have been limited. Patients with existing mental health vulnerabilities, as well as those with no history of mental health struggles, are tackling unforeseen challenges. 

Depression and anxiety can be normal reactions to an abnormal situation. How can we solve residents’ mental health issues when their lives lack real meaning, socialization and stimulation? 

What we cannot do is simply medicate people out of their feelings. Yes, medication can be a useful approach to treating mental health conditions, but it should not  be our first line of defense to addressing emotional pain. Greater attention must be paid to the mental health of our elderly population, and that can be accomplished – at least in part – through behavioral telemedicine services.

Prioritizing by normalizing

Solving behavioral health issues is not a quick fix. It takes time. Telemedicine allows us to engage with residents immediately and gives them a friendly (non-masked) face to help them process thoughts and feelings, which in and of itself has tremendous benefits. 

If we have identified that there is a need to prioritize the mental health of our seniors then we know we need trained professionals to do that. However, there is a critical shortage of mental health professionals that treat the geriatric community and this shortage is expected to increase as fewer psychologists and psychiatrists specialize in treating seniors.

While it is projected that 20% of the U.S. population will be adults 65 years or older by 2030, only 3% of licensed psychologists identify professional geropsychology as their primary or secondary specialty. Telehealth allows providers broader access to these scarce resources.

To benefit from these types of services, seniors must be willing to participate. Many may be hesitant to do that, however, because of the stigma associated with seeking help for mental health issues. Providers can play a major role in eliminating that stigma by increasing access and having behavioral health as part of the regular services they offer. This sends a clear statement that behavioral health is a normal part of your healthcare. Telehealth also allows these appointments to be done in the comfort and privacy of one’s own room. 

Addressing residents’ behavioral health is an urgent need. 

There is no time to waste, and this care cannot be delayed until the pandemic is behind us. It is my hope that behavioral telemedicine services, which empower post-acute facilities to provide better care for their residents and make mental health services more accessible and scalable, experience increased adoption before it is too late to ensure the mental well-being of the country’s resident population. 

An immediate, long-term investment in behavioral telemedicine is the only path forward if we hope to adequately address the mental health and well-being of our country’s long-term care residents.

Sherie Friedrich, Psy.D., is chief psychologist at MediTelecare, where she has focused on the growth and development of the Department of Psychology. Friedrich has worked in psychiatric hospitals, community mental health settings and in private and group practice. She also worked as a psychological consultant conducting comprehensive evaluations for state and private institutions.