Although policy changes during the COVID-19 pandemic enabled physicians to deliver care via telehealth, people of all ages from across the country remain without access to such care due to a lack of reliable internet service and/or computers.
“While a large majority of youth in the United States have internet access, about 14% of youth ages 6 to 17 live in homes without internet and 17% of youth ages 3 to 18 live in homes without computers, numbers which translate to approximately 11 million youth without access to the internet,” wrote Marie Smith-East, Ph.D., D.N.P., and Shaquita Starks, Ph.D., A.P.R.N., in a Letter to the Editor in the Journal of the American Academy of Child & Adolescent Psychiatry. Failing to address the needs of youth without access to the internet and/or computers can serve to marginalize them and may widen pediatric mental health disparities, they continued.
Smith-East is director of the Psychiatric Mental Health Nurse Practitioner Program at Duquesne University School of Nursing. Starks is a family psychiatric mental health nurse practitioner at Emory University Nell Hodgson Woodruff School of Nursing.
Smith-East and Starks offered several recommendations for connecting youth without internet access and/or computers to remote mental health care, including the use of telephone consultations with psychiatrists; buses that go into local communities equipped with internet service and laptops, where patients can access telehealth appointments; and community internet hubs where youth can access the internet outside their home for telehealth appointments.
“For youth without internet but who have insurance, policies could be developed to mandate that insurance companies reimburse patients for internet service or have a mobile wi-fi device sent to them for use during their appointments with their psychiatric providers,” Smith-East and Starks continued. “For youth without insurance who typically use community mental health clinics, federal funding for grants should include the ability to apply for mobile hot spots or innovative approaches to reach patients without internet access.”
They concluded, “Until more disadvantaged youth, especially low-income minority youth, have internet access and either computers or smartphones, they will continue to be left out of the fast-paced technological changes occurring in U.S. health care settings, and this will undoubtedly result in deteriorating mental health outcomes,” they concluded. “The long-term effects of lack of access to reliable internet services for mental health care should thus be of critical concern, as negative mental health outcomes in adolescence typically continue into adulthood.”
For related information, see the Psychiatric News article “The COVID-19 Pandemic and Virtual Care: The Transformation of Psychiatry” by Jay Shore, M.D., M.P.H., and Peter Yellowlees, M.B.B.S., M.D.
(Image: iStock/izusek)
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