The Pros and Cons of In-Person and Virtual Modalities for Mental Health Care
During the height of the pandemic, video counseling and other digital modalities were a lifesaver for millions of people when the option for in-person care was almost non-existent. Now that most providers are seeing clients in person again, the way evidence-based care has been delivered for decades, how will people choose to access care?
This blog will explore:
The evolution of mental health care delivery before, during, and after the pandemic
Survey results on why employees are returning to in-person care
The pros and cons of both in-person, virtual and digital support options
Trends in training and crisis response services for both individuals and organizations
Thoughts on the future of mental health care delivery and the importance of choice and preference in the equation
How the pandemic influenced mental health care modalities
According to CuraLinc’s member data, before the pandemic, 79% chose in-person care over any other option. Even though video counseling was readily available, most users preferred receiving care in person.
Between March 2020 to June 2021, when nearly all counselors and coaches could only provide care virtually, the percentage of in-person care delivered dropped to just 7%.
Now that many providers have reopened their doors to in-person treatment, we’ve seen a resurgence in requests for in-person support: EAP participants have preferred in-person care over video almost 2:1 across our book of business.
The availability of virtual care services was a lifesaver for millions of people during a truly unprecedented time. However, switching to virtual or digital care options wasn’t a personal choice for many people – it was the only option.
In the future, will the preference for in-person care return to pre-pandemic heights? Probably not. Many people who tried video counseling or coaching or other digital modalities such as text therapy appreciate the convenience of video or virtual care – and will continue to use it.
What drove the preference for in-person care after the pandemic?
We surveyed a random sample of participants who requested in-person counseling over video counseling between December 2021 through December 2022 and asked them why they preferred in-person care over video counseling.
The top reason – which nearly half of all participants selected – comes down to choice. Participants reported that they never wanted to switch to video counseling in the first place. Video counseling was a temporary solution for them until their preferred method of receiving care and support became available again. Once it did, they jumped at the opportunity to return to in-person care.
Plenty of articles and digital providers are touting the rise in teletherapy visits, suggesting that virtual care continues to be the preferred modality for mental health services. A more realistic insight into this data is that individuals engage in care in a way that aligns with their preferences and needs at a given time.
Pros of in-person care
Providers can complete a more thorough assessment in person by studying non-verbal communication.
In-person care is backed by decades of evidence-based research.
Meeting in person can create a stronger provider-client bond, or therapeutic alliance, which is critical to successful treatment outcomes.
In-person care may be more appropriate for a broader range of clients and conditions, including better clinical outcomes. For example, participants at risk for depression had a 69% symptom reduction using in-person care versus a 59% symptom reduction using virtual care.
Cons of in-person care
In-person care requires transportation to and from appointments, which costs time and money.
Providers may be limited in rural areas. In fact, over one-third of Americans live in areas lacking mental health professionals.
Some workforce mental health providers lack network depth for in-person appointments.
Pros of virtual care
Seeing a provider virtually may mean less wait time before the first appointment.
Virtual care improves access in rural areas.
Virtual appointments are convenient, saving time and money spent commuting.
Cons of virtual care
Establishing a strong connection between therapist and client can take longer and be more challenging due to the less intimate format of a virtual setting.
Internet and technology problems during the session could create uncomfortable interruptions.
Finding a quiet and secure place at home or work can be difficult for some participants.
Virtual care is less suitable for particular clients/conditions, especially high-risk clients with severe/acute mental health concerns, couples and children.
How returning to in-person organizational support impacted participant satisfaction
During the pandemic, everything went virtual, including crisis response and training services. As we transition into a post-pandemic state, we are seeing some interesting trends in preferences for how organizational support services are delivered.
Critical incident response services
We compared how satisfied and engaged people were with critical incident response services provided in person versus via video. The data showed that people who experienced traumatic events, like the death of a colleague or a workplace accident, preferred in-person services.
Organizational training services
Clients are reporting higher satisfaction with virtual training sessions because everyone can access them, regardless of their location. Virtual training also allows a larger pool of skilled experts to lead sessions instead of relying on local resources, resulting in more effective and engaging sessions.
The future of mental health care delivery
High-tech and high-touch should not be mutually exclusive. They are both essential parts of an effective workplace mental health program. As we look to the future, it’s clear that a one-size-fits-all approach to workforce mental health won’t meet most employers’ needs. Digital modalities will continue expanding access to some employees, while others will prefer in-person counseling.
The International Journal of Scientific Research Publications recently published a peer-reviewed study based on the health and productivity outcomes from over 35,000 CuraLinc employee assistance program (EAP) cases that were delivered in person – the largest study of its kind – demonstrating the profound impact of in-person care.
Depression 78% of people at risk for depression were no longer at risk after completing in-person treatment
Anxiety 80% of people at risk for anxiety were no longer at risk after completing in-person treatment
Alcohol misuse 68% of people at risk for alcohol misuse were no longer at risk after completing in-person treatment
Presenteeism 88% of people at risk for presenteeism were no longer at risk and had a level of performance in the range of a typical employee after completing in-person treatment
Absenteeism Employees with an absenteeism problem missed 20.94 fewer hours of work on average in the 30 days after completing in-person treatment
Providers that steer most or all users to video sessions or virtual care or who can’t connect employees to high-quality in-person care in a timely fashion will miss out on engagement and care delivery opportunities with a large portion of almost every employee population.
To facilitate timely access to personalized care, providers must empower choice and preference – allowing employees to choose a modality and a counselor or coach they feel comfortable with.