The pressure on the Dutch mental health care (GGZ) is a growing problem. The shortage of staff and the increasing demand make it difficult to provide timely and appropriate psychological care. As a partial solution, there is now a wide range of eHealth tools that can be used to digitally support part of the care process. Examples include online treatment modules, measurement methods, and chat functions for asking questions. However, it is noticeable that the use of these tools in independent practices is disappointing, while they have the potential to add significant value to treatments. This means that independent mental health care is missing an opportunity to reduce waiting lists.
Research by IG&H among 350 independent psychologists – the group that performs most treatments in basic mental health care – shows that their attitude towards eHealth varies greatly. Many independent psychologists are not enthusiastic about (hybrid) eHealth. They believe that many clients are not interested, find the investments too high, and lack support to make it possible in their own practice.
Division among independent psychologists
The use of eHealth among independent psychologists is currently low. Although 80% of psychologists use some form of eHealth, the frequency is generally 'sporadic to occasional'. When eHealth is used, it is generally to offer a broad and flexible range of care to clients.
To get an idea of the perceived barriers and success factors for the adoption of eHealth, independent psychologists can be divided into two groups: active users and minimal users. The active users (48%) do see advantages. Treatments are more efficient, and sessions are more effective thanks to interim online contact with the client and monitoring of progress. Such a mixed treatment ensures that the therapeutic relationship is maintained and, according to them, has clear benefits for the treatment. These psychologists are clearly positive about further integration of eHealth in mental health care (67%).
On the other hand, there is a group of psychologists who make minimal use of eHealth (52%). They do not yet see the benefits and have very limited knowledge of digital tools. According to them, the use of eHealth leads to a poorer therapeutic relationship, and they sometimes experience resistance from clients. Moreover, this group of psychologists finds the eHealth platforms too expensive, and reimbursements do not provide an incentive. For them, the existing contact is sufficient and yields at least the same results. They also lack the time to really delve into eHealth.
More support and collaboration needed to realize potential value
There is no evidence that digital treatment can eliminate waiting lists, but eHealth can certainly provide some relief. However, a significant portion of independent psychologists remain hesitant. They do not plan to incorporate more eHealth into their practice and are mainly hindered by practical barriers such as a lack of funding or support.
Let's start by removing these surmountable objections and at least give independent psychologists the choice to use eHealth. By supporting them, they at least have the opportunity to experiment with it. The faster and better this occurs, the greater the chance that we can relieve the overburdened mental health care system.
For example, why is there not yet a national development platform? By uniting independent psychologists, knowledge, skills, and costs can be shared. Such a platform also offers the opportunity to share best practices, exchange tips on digitalization, and set up the proper integration into the treatment process in practice. It is crucial that, in addition to psychologists, clients also have a say in such a platform. Insurers also play an important role in financially supporting this, for example, through IZA transformation funds. When they also ensure appropriate funding, the path to more eHealth is open. The adage 'Digital when possible, physical when necessary' can then really start to work.
Walter Kien
Director Healthcare
T: +31 6 29 56 52 08