Telehealth provides mental health services wherever you are

The COVID-19 Pandemic is history now, but the attention it drew toward mental well-being is something that has persisted. As awareness of the issue grew, so did the services around it.

When people had to stay home, mental health services met them there; and for those getting help from Oxbow Center, the opportunity to connect to a counselor remotely over telehealth continues.

Oxbow Center CEO Mary Johnson in Worland (in person) and Chief Program Officer Day Lynn Stebner and Human Resources Officer Terry Ward (appearing remotely) discussed the history of their telehealth services and how they've become a staple for connecting more rural Wyomingites with necessary care.

MEETING THE NEED

As mentioned, pandemic policies kept people indoors in early 2020, but those receiving mental health services were still in need of services - and this need grew as more people sought services, feeling the effects of prolonged isolation. Johnson said, "We offered telehealth in a limited capacity before COVID, but it really became most prevalent in 2020. A lot of health care organizations quickly had to pivot to an online setting, including Cloud Peak Counseling [prior to merging into Oxbow Center last year]."

Stebner (then working at Big Horn Basin Counseling in Lovell) and Ward (then employed at Yellowstone Behavioral Health Center in Cody) said their respective services did much the same.

"We all immediately shifted to telehealth because we wanted our clients to maintain access to services; and when we had those health concerns, and social distancing and such things were at play, we really had to start utilizing telehealth as a platform to serve our clients," added Johnson.

She continued, "Behavioral health issues didn't go away; in fact, they probably escalated for some people during that time ... Wyoming did a really good job in their response. They created the Wyoming Telehealth Network, and that allowed all of us providers access to a HIPAA [Health Insurance Portability and Accountability Act] compliant Zoom platform. People get concerned about confidentiality when it comes to telehealth, so that was really neat."

Soon after the pandemic started, mental health providers across Wyoming were able to offer group counseling, individual counseling and case manager meetings - all remotely through the secure Zoom platform. Appointments to discuss billing were not initially approved due to a delay from insurance providers adapting their policies, but that followed to the online format soon after.

From the start, clients needed three things to engage in telehealth: internet access, a device to use it and a private place to sit. Clients onboarding into the service were taught how to use it, and the providers interviewed indicated that technical difficulties were never much of an issue.

It took some getting used to, but clients' needs were met through telehealth; some liked it more than others, but it quickly became clear that it had unique benefits.

LESSONS LEARNED

With the era of online-only meetings behind them, the representatives spoke about what providing telehealth services taught them.

Johnson said, "Of course in-person services can't be replaced, but I think preferences vary for individuals. We have noticed that some are more comfortable on Zoom than they are in-person, just based on the disorder that we're treating or their personal preference ... Initially, many people thought that there would be major barriers associated with being on screen, but it has proven to be effective for individuals, and I think it has allowed people access to care when they might not have left their home before."

Ward added, "After the pandemic we offered both kinds of services, and this has allowed our therapists more flexibility and comfort as well ... they have a greater reach personally ... So it's a good thing for our therapists as well."

Stebner said, "I think a lot of the benefit of this technology is getting around transportation issues. A lot of our clients may have trouble getting here, and we have limited public services for transportation in our communities, so that's been a really big help ... With our merger now, clients can access therapists from all across our agency. If they're seeking a specific type of therapy or a different group, it has really opened that up for clients. Or maybe they don't want to see anyone in their community and they want the privacy telehealth offers; they can request a therapist in another community. That's been really beneficial as well."

CONTINUED COMMITMENT

In the Big Horn Basin, they were united by a common goal in 2020; making sure those in need of services could receive them wherever they were. Stebner said, "That was one of the things that our three agencies worked together on during the pandemic; ensuring that we were able to serve the individuals in all our communities across the region. That played a big part in starting our partnership."

Mental health service providers in Worland, Basin, Cody, Lovell and Powell built a working relationship by connecting clients with counseling in neighboring communities to meet their needs. Conversations about how they could grow in partnership began in 2021, and those talks led to Cloud Peak Counseling, Yellowstone Behavioral Health Center and Big Horn Basin Counseling merging into one unified provider under the name 'Oxbow Center' on April 1, 2024.

In an article published on March 21, 2024 Johnson is quoted saying, "In these rural pockets of Wyoming, it's difficult for people to find specialized care. So, if someone needed to see a family therapist, if we didn't have someone certified with what they need here, one of our partners might. We want to be able to have services offered across organizations ... That way we can enhance and increase the services that we're offering our communities, while we're adding efficiencies to our business operations. It's kind of a win-win situation. By working together, we are working stronger."

TELEHEALTH TODAY

The strength Johnson mentioned then has manifested as Oxbow Center offering their full list of services - both in-person and via telehealth - across Washakie, Big Horn and Park counties. Many of their telehealth services require clients to use a camera to verify their safety and privacy, but the primary requirements remain the same: internet access, a device to use it and a private place to sit.

Now, for clients who wish to access telehealth services but lack the means, Oxbow Center offers a private computer room where clients can join in.

Johnson added, "Another service we've opened is a virtual walk-in clinic that's open Monday through Friday, 8 a.m. to 5 p.m. So, if someone is in a crisis and needs to talk to someone, they're able to connect with a clinician. We have a link to that service on our website, all you need is internet and a device that can access it ... We don't ask the individual to fill out paperwork prior to that, they can just hop in and get help."

From OxbowCenterWy.org, a visitor to the site can click the 'Telehealth Services' button on the top right, then the 'Zoom Meeting' button that follows. From the homepage, two clicks is all it takes to talk to someone.

The continued demand and the connecting capabilities of telehealth have proven that it's more than a response to social distancing; it's here to stay.

"Part of our mission with Oxbow Center is to reduce the stigma around receiving mental health services. Telehealth is really providing that for a lot of people - especially in the state of Wyoming, in the rural areas - by getting them those services wherever they are."