Medhealth Review

Mental health patients can wait up to 18 months for treatment. How can at-home neuromodulation help close the care-access gap?

According to the World Health Organization, 1 billion people are estimated to suffer from a mental disorder1. Furthermore, 5% of adults (or around 280 million people) are estimated to live with depression, which is a great contributor to the global burden of disease and the leading cause of disability worldwide.

In the US alone, the incremental economic burden of adults with MDD was calculated to be more than $325 billion (2020 values). Meanwhile, in Europe, the total costs of mental health problems are estimated at more than 4% of GDP — close to $660 billion. 

While depression is recognized as a major global concern, access to care remains inaccessible to many. Globally, the World Health Organisation estimates that 75% of sufferers of severe depression do not receive adequate help (WHO, 2017). The key problem is a major lack of resources in healthcare. There aren’t enough psychiatrists available to tend to everyone who needs help, and less than half of the people who actively seek help are able to receive it. In the US, it is estimated that there is only a single psychiatrist per 10,000 people, and wait times for mental health appointments range from 3 to 18 months.

Closing the inequality gap in healthcare access can be assisted by expanding access to remote, home-based neuromodulation treatments, such as transcranial direct current stimulation. These are safe and effective options that can make access to treatment easier and more flexible for both patients and medical professionals. In Nordic European countries like Finland and Estonia, home-use tDCS devices may be prescribed by a family doctor. 

Effectively instituting at-home neuromodulation care

The first step to developing effective home-based therapies is evaluating patient eligibility. At-home neuromodulation care can be especially suitable for patients with stable, non-life-threatening conditions who can actively participate in their own care. Factors such as the severity of the depression, the patient’s ability to self-manage, and the presence of a supportive environment should be assessed.

The next step is vital. Treatment should be coordinated in conjunction with a healthcare professional. This entails medical prescription and supervision of home-based brain stimulation therapies to maintain treatment quality. Collaboration among healthcare providers — including physicians, nurses, and therapists — with patient involvement is crucial. Together with the establishment of clear communication channels, standardized protocols, and secure methods for the sharing of patient information, the clinician can facilitate effective coordination and seamless transitions between healthcare settings.

The third step is training. Comprehensive training should be provided to all actors involved in at-home treatment processes: patients, caregivers, and healthcare professionals. This includes education on disease management, device operation, and safety protocols. Such training will empower patients and caregivers alike to actively participate in the care process and ensures optimal treatment outcomes.

Besides the active involvement of healthcare professionals and patients, the development of these effective home-based treatments requires the participation of insurance providers. After all, access to these therapies not only hinges on their accessibility but also their affordability. While many insurers have made strides to reimburse in-clinic neuromodulation procedures, there is still much work to be done to cover the comparatively more affordable home-based solutions

By considering these factors, safe and effective home-based therapy solutions can be developed, prioritizing patient safety and well-being while providing greater flexibility in access to care.

Empowering patients and clinicians with home-based treatments

Home-based treatments for non-critical or life-threatening conditions with safe and simple-to-use devices can provide convenience to patients and reduce healthcare professionals’ workload. Moreover, these devices can improve treatment adherence, as patients can self-administer the therapy sessions at home under the prescription and supervision of a healthcare professional. Transcranial direct current stimulation (tDCS) devices provide a safe and effective treatment method that patients and caregivers can safely self-administer at home after a training session with a healthcare professional.

The integration of remote monitoring capabilities into home-use medical devices could help healthcare professionals perform real-time assessments of treatment adherence and progress while monitoring potential adverse events. This functionality could further support patients by providing ongoing support and guidance throughout their treatment, even in non-clinical care settings.

At-home outcome self-reporting assessments can also facilitate the evaluation of treatment efficacy and patient response. Through the use of mobile devices connected to the brain stimulation medical device in question, patients can provide feedback on their treatment progress from the comfort of their homes using validated questionnaires, remote tests, or self-reported outcome measures. These data can assist healthcare providers in making informed decisions and adjustments to the treatment plan.

Home-based depression treatment with tDCS devices, supported by remote monitoring and self-reporting assessments, can offer a valuable alternative for patients who are unable or prefer not to access traditional treatment options such as drugs or commuting to clinical settings. By leveraging technology and promoting patient-empowering initiatives, we can improve treatment accessibility, enhance patient outcomes, and use home-based healthcare models to help narrow the mental health treatment gap.

By Tuomas Neuvonen, CEO at Sooma Medical

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