Sandhya Prashad, MD is medical director at Houston Ketamine Therapeutics and Houston Deep Transcranial Magnetic Stimulation (TMS) Therapy.
There is no question that the pandemic has shaped myriad aspects of life as we know it, including significantly impacting the mental health care industry. While the unprecedented events have resulted in mental health challenges, it has also delivered growth in the area as well.
In fact, the appetite for treatment has increased so much that providers are finding it challenging to accommodate the surge of requested appointments.1 This new found openness among patients to explore therapy has served as a means to deliver more care to those who have lived in silence for years due to either apprehension around going into an office or limited understanding around just how far treatment options have come.
Teletherapy has helped shepherd more patients through the door
Leveraging teletherapy has helped providers and patients troubleshoot the common concerns around social distancing and, ultimately, could be credited with getting many first-time patients in the “virtual” door. In fact, the use of teletherapy saw a 154% increase in March 2020 when compared to the same period in 2019.2 The ability to connect with patients in the comfort and privacy of their own homes allowed providers to build rapport over time and helped spark many overdue conversations around tailored options for treatment. While the convenience of teletherapy is likely to foster continued use long after the pandemic subsides, it is important for providers to remind patients that it is not a direct substitute for an in-person visit nor is it the only form of treatment available.
Taking the next step in treatment with the latest technology
Marrying the increased desire to speak with providers and the ability to ease into sessions via virtual visits, providers like myself have a unique opportunity to begin educating patients that mental health treatment is not a one-size-fits-all approach. Studies have shown that depression symptom prevalence is more than 3-fold higher3 during the COVID-19 pandemic, and because more than 40% of people with major depressive disorder (MDD)4 find they are treatment-resistant, there is a growing need to foster education among patients regarding other available options when there is an unresponsiveness to traditional methods.5 These options include deep transcranial magnetic stimulation (Deep TMS), a noninvasive treatment process that is FDA-cleared for treating depression and obsessive-compulsive disorder (OCD). While well-known within the mental health community, many patients are unaware of this successful treatment option which only takes 20-minutes per session.
In a study published by the Journal of Psychiatric Research, Deep TMS therapy combined with standard medication for MDD was found to be significantly more effective than standard pharmacotherapy alone, reducing the symptoms of close to two-thirds of participants battling depression.6 Deep TMS is a great example of how far we have come in treatment offerings, showing patients that there are treatments that do not require downtime, are noninvasive, and offer virtually no discomfort.
Moving forward in the new normal
While we as a society are working hard to leave the pandemic behind as a footnote in history, we as mental health professionals have been given a catalyst for a mental health movement. The pandemic has helped break down barriers such as the stigma around treatment, access to care in terms of proximity and available time, and even common misconceptions of what it means to receive treatment for depression. It is our responsibility as those committed to improving mental health to look for every opportunity we can to serve and educate, and the pandemic has certainly provided us with a platform.
Sandhya Prashad, MD is a board-certified psychiatrist specializing in interventional modalities for treatment-resistant disorders with a particular interest and expertise in ketamine therapy. She is the founder and medical director of Sandhya J. Prashad, MD, Houston Ketamine Therapeutics, and Houston TMS Therapeutics. Dr Prashad currently serves as president of The American Society of Ketamine Physicians, Psychotherapists and Practitioners.
1. Caron C. ‘Nobody Has Openings’: Mental Health Providers Struggle to Meet Demand. The New York Times. https://www.nytimes.com/2021/02/17/well/mind/therapy-appointments-shortages-pandemic.html. Published online February 17, 2021. Accessed February 17, 2021
2. Koonin LM, Hoots B, Tsang CA, et al. Trends in the use of telehealth during the emergence of the COVID-19 pandemic — United States, January–March 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1595–1599. doi:10.15585/mmwr.mm6943a3
3. Ettman CK, Abdalla SM, Cohen GH, Sampson L, Vivier PM, Galea S. Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw Open. 2020;3(9):e2019686. doi:10.1001/jamanetworkopen.2020.19686
4. Major Depressive Disorder and TMS Treatment. Brainsway. https://www.brainsway.com/knowledge-center/major-depressive-disorder-tms-treatment/. Accessed February 9, 2019
5. Jaffe DH, Rive B, Denee TR. The humanistic and economic burden of treatment-resistant depression in Europe: a cross-sectional study. BMC Psychiatry. 19, 247 (2019). doi:10.1186/s12888-019-2222-4
6. Filipčić I, Šimunović Filipčić I, Milovaca Z, et al. Efficacy of repetitive transcranial magnetic stimulation using a figure-8-coil or an H1-Coil in treatment of major depressive disorder; A randomized clinical trial. J. Psychiatr. Res. 2019;114:113-119. doi:10.1016/j.jpsychires.2019.04.020