Consumer-Therapist-Connector: Increasing Access to Quality Behavioral Healthcare

ABSTRACT The United States is experiencing a major mental health crisis that persists post-pandemic. Per recent media reports, the gap between need and access to behavioral health services is rapidly increasing. There is an urgent need to solve both the access and quality problems with behavioral healthcare. One study found that 76% of surveyed employees are reporting at least one significant behavioral health symptom. Another report indicated that adults are on waitlists for 3+ months to receive outpatient therapy in Massachusetts. There simply are not enough therapists to meet the increasing demand and waitlists are long and growing. On the quality side, more than 60% of patients find no meaningful benefit from the treatment they receive. We have already created an innovative system called TOP Match that improved the quality problem in a randomized clinical trial: matching to therapists’ measurement-based and problem-specific strengths roughly doubled patient improvement levels, relative to usual case-assignment methods. In this proposal, we simultaneously aim to solve the access problem by finalizing, customizing, and testing our next innovation: Express Access. The Phase I feasibility tests of Express Access were successful: Focus groups conducted with multiple stakeholder groups (patients, therapists, and staff) identified key themes about content and functionality (e.g., scheduling, preferences, features) to incorporate into the prototype (Aim 1). Their input informed the development of two interactive prototype flows: one for patients and one for staff (Aim 2). The prototype received usability and acceptance ratings that exceeded the feasibility criteria (Aim 3) and generated valuable input to be used during Phase II design and development. This proposed online system, Express Access, will expeditiously connect patients who are seeking behavioral health referrals from their Primary Care Physicians with well-matched therapists for traditional therapy by distance search, or telemedicine by state or national searches. What distinguishes our solution from other online find-a-therapist systems is that patients can instantly add themselves to the waitlist of all empirically well-matched providers, encouraging consumers and providers to offer and accept appointments when a match is likely to greatly benefit the patient, thus increasing the likelihood patients will connect quickly with a good-fitting therapist. To achieve our Phase II Aims to develop and test Express Access, we have engaged two key clinical partners: Grow Therapy, one of the largest national providers of behavioral healthcare, and the American Academy of Family Physicians (AAFP), the largest association of primary care physicians to work with us.