Current Trends in Psychiatry: Building Awareness to Deliver Optimal Clinical Outcomes
by Micah Hoffman, MD, DABPN, FAPA
AllMed Behavioral Health Medical Director
Like so much of our world, psychiatric practice and research are undergoing major transformations, many related to the COVID-19 pandemic. Understanding these changes is essential for health plans working to provide the best outcomes to members using resources available within a given plan. In this article, I’ll discuss recent trends and how board-certified psychiatrists from AllMed can help plans gain the comprehensive awareness needed to meet today’s mental and behavioral health challenges effectively.
The Pandemic Effect
Across the board, COVID-19 has exacerbated mental health disorders, further straining an already overtaxed mental health system. During the pandemic, four in 10 adults in the U.S. reported symptoms of anxiety or depressive disorder compared to one in 10 in January – June 2019.1 In addition, many reported specific negative impacts on their mental health and well-being, including difficulty sleeping (36 percent) or eating (32 percent), increases in alcohol consumption or substance use (12 percent), and worsening chronic conditions due to worry and stress over the coronavirus. 2
Spotlight on Emerging Trends
Within the category of substance-related disorders, a new phenomenon is gaining attention. The rise in alcohol disorders among women is a trend that’s being studied throughout psychiatry and the wider world of medicine. Even before the pandemic, rates of alcohol use, heavy drinking (defined as four or more drinks on one occasion), and related disorders among women were on the rise. Between 2001–02 and 2012–13, there was a 16 percent increase in the proportion of women who drink alcohol, a 58 percent increase in women’s heavy drinking (versus 16 percent in men), and an 84 percent increase in women’s one-year prevalence of an alcohol use disorder (versus 35 percent in men).3 These increases were attributed, in part, to changing norms around female alcohol consumption and the alcohol industry’s targeted marketing strategy. Once COVID-19 arrived, according to a RAND Corporation study, women increased their heavy drinking days by 41 percent compared to before the pandemic.4 Interestingly, additional research has shown that the psychological stress related to COVID-19 was associated with drinking greater quantities for women, but not men.5
In parallel to pandemic-related trends, we are also seeing a spotlight on the rapidly evolving field of gender-affirming care. Many members are investigating their options, and plans are seeking guidance to support members appropriately. The World Professional Association for Transgender Health (WPATH) is slated to release the latest standards of care soon, likely within the second quarter of this year.
We at AllMed are watching closely for the WPATH guidance, which is followed by most health plans. In addition, we have formed a gender-affirming care panel that is specific to behavioral health. The panel brings together experts in the areas of behavioral health, including child and adolescent psychiatry, urology, plastic surgery, OB-GYN, and endocrinology to help plans and members navigate at the intersection of the guidelines, what is happening in clinical practice, and health plan policy to determine the most appropriate treatment plan.
Expertise When You Need It
As this discussion highlights, the need for mental and behavioral health treatment has not only grown during the last several years but has evolved, taking on new characteristics. At the same time, the number of psychiatrists has continued to decline. Because of the psychiatrist shortage, many people who seek help reach out first to a family or internal medicine physician or other primary care provider. In these cases, particularly when first-line standard treatments are not effective, it may be beneficial to obtain guidance from a trained psychiatrist. This is where AllMed can help. Our board-certified psychiatrists carefully review and evaluate the details of the member’s record and experience to date. Often, we are able to suggest relatively simple, evidence-based adjustments to a member’s prescribed regimen to help them get well within the parameters of their plan.
At AllMed, our focus is on meeting members’ needs with evidence-based treatment that aligns with plan policy. Our board-certified, practicing psychiatrists draw on their extensive clinical experience and familiarity with the latest research to support your team with guidance on the most appropriate treatment and level of care for each member. Partnering with AllMed ensures that you have access to the expertise you need to keep up with current trends and steer treatment in the right direction.
In our next article we’ll take a look at recent advances in treatment options, including psychopharmacology for treatment of mood disorders. Check back in this space.