Electronic Health Reporter

By Justin Hunt, MD, MS, head of psychiatry, Ginger.

From banking to healthcare to grocery delivery—businesses and organizations across multiple industries are pivoting to leverage text messaging as a way to reach consumers. And in behavioral healthcare, text-based coaching is paving the way for increased access to support. Traditionally, mental healthcare providers have only offered in-person appointments for individuals seeking care. Today, virtual services like teletherapy and telepsychiatry are gradually growing in popularity among an increasingly tech-savvy population. Now, services like text-based behavioral health coaching offer another meaningful way for individuals to get in-the-moment care.

Consumer Expectations Have Shifted

Consumers today expect instant access to mobile-first, on-demand services. A recent survey by the Harris Poll on behalf of Ginger revealed that Americans–especially Millennials–are more comfortable with the idea of being able to text for mental health support as a way to get access to care. Two-thirds of Americans (66%) say that if they were struggling with stress or life challenges, they would prefer to text immediately with a certified mental health coach who is trained to provide support if given the choice, while 34 percent would choose to wait three weeks to meet with a licensed therapist in person. This trend is strongest with the Millennial population: 69 percent would prefer to text immediately with a professional rather than wait to meet in-person.

For many consumers, a chat-based solution may be less intimidating as a first step than going in-person to see a licensed professional. Coaching is emerging as a way for individuals to access support in overcoming day-to-day challenges, reach goals, and learn skills to reduce stress. While not licensed like a traditional provider, coaches do have credentials like coaching certifications or master’s- and doctoral-level backgrounds in mental and behavioral health. And just this year, the American Medical Association approved new codes for health and well-being coaching. Individuals can work with coaches alongside a therapist and psychiatrist to receive support between appointments and sustain the progress they’re making toward personal growth. Coaching is also effective as a preventative layer of mental healthcare. At Ginger, 68 percent of our members are non-severe and don’t require intensive therapy or medication management.

Text-based Chat is the New Normal

The younger generations that are digital natives have grown up with texting and chatting online as a regular, highly expressive form of communication. It comes as no surprise that they would be comfortable expressing themselves in this way to mental healthcare providers. For them, text-based chat with a coach can help them find meaning and healing. Additionally, both therapy and psychiatry are episodic in nature—with clinicians meeting clients bi-weekly or monthly. But as I’ve found in my work as a psychiatrist, life does not operate on that schedule.

While clients might demonstrate an overall trajectory of improvement, unexpected mini-crises in between appointments can slow down improvement. Immediate coaching intervention at the exact time of need helps to address these natural setbacks that occur between therapy or psychiatry visits. In addition to handling acute issues, coaching can offer a helpful longitudinal approach to goal setting. For example, coaches can check in with clients between clinical visits and remind them of healthy sleep hygiene techniques or provide light motivational interviewing to help an individual reduce alcohol consumption.

Scaling Care to Meet Demand

As mental health stigma decreases, more people are actively seeking services. Earlier this year, in partnership with Dimensional Research, Ginger surveyed more than 1,200 U.S. workers and found that a growing number of workers are proactively seeking out mental healthcare. Fifty percent of workers said they are more likely to seek help now than they were five years ago and 85 percent reported that behavioral health benefits are important when evaluating a new job.

Yet, the mental health industry isn’t adequately resourced to meet this growing demand. Research shows that 60 percent of U.S. counties are without a single psychiatrist and the average wait time for mental health appointments is up to 25 days. Digital solutions, such as text-based coaching, teletherapy, and telepsychiatry make it possible to provide care to individuals in rural areas where there aren’t as many clinicians. Chat-based coaching is also available 24/7, making it possible to get care in-the-moment. Coaches can then help to triage individuals to evidence-based psychotherapy or to psychiatry if medication management is also needed.  

Services like coaching can ensure that licensed professionals are able to scale their services and practice at the top of their licenses. When individuals face daily stress and other challenges that don’t necessarily require intensive psychological treatment, they should have access to coaches who can offer support and guidance. This reduces the load on the industry as a whole, which can help to prevent clinician burnout—an all-too-common side effect of an overloaded care industry. The ultimate goal is to get individuals to the right care at the right time while using limited licensed therapy and psychiatry resources wisely.

Text-based coaching is an impactful way to open the door to mental healthcare. By making emotional support available 24/7 through an individual’s mobile device and as easy as texting with a friend, we can ensure that more people get the support that they need.