President and CEO of Lucid Lane. Software technology expert and digital health advocate.
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The Covid-19 pandemic has shifted every activity online, from meetings to classes to happy hours — and therapy is no exception. With remarkable speed, therapists have learned to provide personal, empathetic mental health care over video calls. This adaptability has been a bright spot in a dark time and a lifeline for many patients who've been able to get the care they need while staying safe at home.
However, this incredible shift to remote therapy has left some people behind: those without stable broadband internet access. The vulnerable populations who don't have reliable internet access are often precisely the people who could benefit most from teletherapy even after Covid-19 is finally brought under control. As the pandemic wears on, it's becoming increasingly clear that broadband access is a mental health issue and that solving this country's mental health crisis will require getting more people online.
The ubiquity of the internet in the majority of Americans' lives today obscures the many access problems that still persist. According to studies conducted by Pew Research, nine out of 10 American adults use the internet, and internet usage continues to grow for all demographic groups — although older adults are still less likely to be online. While 100% of people between the ages of 18 and 29 and 97% of those between the ages 30 and 49 are online, only 73% of people over the age of 65 are connected. Broadband internet access, meanwhile, is less widespread. Pew Research found that only 73% of American adults have a high-speed connection at home — including only 59% of those over the age of 65. The rate of broadband adoption grew quickly between 2000 and 2010, but that growth has slowed significantly in the past 10 years.
It's not just age that affects broadband access; race, income and location also play a role. Pew Research found that 79% of people who are white in America have broadband access, compared to only 66% of people who are Black and 61% of people who are Hispanic. People living in suburbs are the most connected, with 79% of them having home broadband access, while 75% of city dwellers and only 63% of people living in rural areas are connected to broadband.
What all this means is that, sadly, some of the people who are suffering the most from the mental health impact of this pandemic will be shut out of an otherwise excellent tool for expanding access to mental health care.
Older adults who are at greater risk for severe illness from Covid-19 may have been isolating themselves for nearly a year now, unable to see friends and family members or hug their grandkids. The long-term mental health impact of that social deprivation may be severe. Remote therapy can be a lifeline for people who struggle to leave the house because they're frail or suffer from other health problems as well as for people who would otherwise have to travel long distances to obtain care. However, there are millions of older people and people living in rural areas who don't have the high-speed internet access they need to do regular video calls.
High-speed internet also widens access demographically, connecting more diverse patient populations with a broader range of mental health care providers. According to a report published by the CDC, we already know that 40.9% of Americans have dealt with at least one serious mental health issue during the pandemic, but many more people who are Black and Hispanic are struggling. It found that 18.6% of adults who are Hispanic and 15.1% of adults who are Black had seriously considered suicide in the past month, compared to 10.7% across the general population.
Many people of color have urgent mental health needs right now, yet many are lagging behind in terms of home broadband access. That means millions of people are likely struggling to get regular access to the mental healthcare they need and will continue to lack access to a powerful tool in the mental health arsenal.
We were already dealing with a simmering mental health crisis in this country even before Covid-19 hit. Now, millions more are dealing with grief, unemployment, the after-effects of serious illness and the stresses of long-term isolation. We've learned during the pandemic that remote therapy via video chat can be extremely effective, and it's clear that teletherapy will continue to be a useful option after the worst of the pandemic has passed. The remote option increases access for people in rural areas or with multiple health issues, and it's also convenient for many busy working people.
Teletherapy also enables people to connect with niche mental health services that might not be available locally. My company, Lucid Lane, specializes in medication tapering, helping patients reduce their usage of opioids and benzos over time. Online support groups exist for highly targeted groups like health care workers, teachers struggling with virtual learning, new or expectant moms — the list goes on. It's difficult to find such resources in your neighborhood, and online participation is the only viable option during a pandemic.
However, you can't get therapy online if you can't get online with a reliable, high-speed connection that can support a video call. If we're going to meet the severity of the mental health crisis in this country with every tool we've got, we're going to need to get more people online. We must increase broadband access — particularly for those populations who lag behind in access today, including people in rural areas, older adults and people of color.
As technology changes and we develop more innovative solutions to serve more people, we can't settle for leaving millions of people behind simply because they don't have a high-speed internet connection. Today, broadband internet access is a justice issue, as the struggle to connect low-income students and students of color to remote learning has proved. However, it's also a mental health issue. Remote therapy could be one of the most powerful tools we have for tackling our mental health crisis — but only if everyone who needs it has access to it.
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