Instead, his private counsel and his psychiatrist tried a new method of meeting, which didn’t require Douglas to leave his apartment. It was wireless telehealth counseling, and medication sessions. This type of treatment has seen a surge in Mississippi during shelter in place orders. While it is not possible to quantify the rise in Douglas’s telehealth via private insurance, numbers for those who are covered by Medicaid soared. “In the state fiscal year 2019, there were 6,078 total visits to telehealth for mental health services. Matt Westerfield (communications director for Medicaid) stated that there were more than 14,852 telehealth visits to mental health services between March 1 and May 25, 2019, which is roughly three months. At first, Douglas was not interested in telehealth. Douglas had been going to his counselor every other week since January. He didn’t want the support he’d received since November, when he was experiencing stress from law school and a breakup. He finished law school in summer and is now enrolled in the MBA program. Douglas stated that he felt like it helped him keep going. Although he didn’t make the most progress in his treatment, he said it prevented him from regressing to a deeper episode. Mississippi approved telehealth for one or more chronic conditions as defined by Centers for Medicare & Medicaid Services. This includes mental health. The telemedicine service must be covered by an employee benefit plan or health insurance. It must also have the same deductible and co-payment for telemedicine services as for in-person consultations. The main obstacle to Mississippi’s mental health centers using Telehealth regularly was that Medicaid didn’t reimburse them for much of the care provided over telehealth. Instead, they required that the patient be seen by a physician. In response to the pandemic, Mississippi’s Division of Medicaid created an Emergency Telehealth Policy. “Essentially, the emergency policies temporarily raise the number of eligible services for telehealth, and give providers flexibility to deliver these services via audio-only modes of communication,” stated Phaedre Coll, executive director of Region 6 Community Mental Health Center, and board president of the Mississippi Association of CMHCs. Westerfield stated that this is especially important for mental health because beneficiaries can avoid unnecessary travel and possible exposure to coronavirus, while still receiving regular support. Cole stated that virtually every Mississippi Medicaid mental health service can now be accessed via telehealth. These include programs like individual therapy, group therapy and peer support. Cole noted that such emergency policies would end June 30. “It is our hope, that these emergency policies are extended.” Westerfield said that while the number hasn’t increased, it simply means that beneficiaries have used telehealth less frequently. “We don’t see a significant increase in beneficiaries receiving mental health services due to telehealth. The volume of billing claims was comparable to pre-COVID-19.” Cole stated that visits can be provided via any of the available channels, such as FaceTime, Skype, GoToMeeting or just a telephone conversation. Before the pandemic, telemedicine and telehealth were a hot topic. An analysis published in 2016 in the National Institutes of Health’s Telemedicine Journal, and E-Health examined the possibility of using “telemental health” to treat mental disorders. This was done in an attempt to mitigate the shortage of mental health professionals. The study found that the United States has a shortage of between 10,000 and 20,000 psychiatrists. There are also serious shortages of child, adolescent, and geriatric psychiatrists. Telemedicine was evaluated for its feasibility, acceptance, effect on medication compliance, cost, and health outcomes. According to the analysis, the global cost of mental disorders is expected to exceed $6 trillion by this year. Based on 22 studies that examined the feasibility and acceptance for telemental health, seven of which looked at medication compliance and five dealt with cost, the analysis was done. All feasibility and acceptance studies came to similar conclusions about satisfaction. The majority of treatment adherence reports positive results regarding medication compliance. Cost-effectiveness was dependent on volume, with 250 consultations being the minimum volume saving. Cole stated that while telehealth visits in Mississippi have increased dramatically since the outbreak of the pandemics, there are still barriers for patients with mental disorders who seek care. Many of our clients do not have broadband access, lack the skills or equipment to use telehealth services, are not able to pay for data plans or do not want to use up their minutes by making long or frequent telephonic calls. Telephonic only meetings can also cause valuable clinical information to be lost. Douglas stated that his first attempts to telehealth visit him were hampered by technical difficulties. He was unable to log in to the clinic’s telehealth software. His providers and he finally used FaceTime to complete his sessions. Douglas stated, “It’s been a adjustment.” Douglas said that he sometimes found it difficult to talk to his problems in private due to the presence of his roommates. Cole said that mental health professionals know that social isolation can have severe consequences for people’s mental or physical health. Cole stated that experts believe the decrease in cases of coronavirus will allow for face-to-face communication between patients and their clinicians. “The pandemic caused social isolation on the masses. Although telehealth and other telephonic services can provide some human contact, they do not replace face-to-face interventions. Douglas stated that he started regular in-person sessions last week and was happy about it. Douglas stated that it was strange to receive therapy in his own room. “I don’t know if I got as many out of it.”_x000D