Amwell’s Anthony Sossong talks about telemedicine, kids and mental health

With children facing tremendous behavioral health struggles, telemedicine offers a chance to provide care to kids who sorely need it, Anthony Sossong says.

Sossong is the chief medical director in behavioral health for Amwell, the telehealth company based in Boston. Amwell has partnered with 2,000 hospitals and health systems. The company recently announced a partnership with CVS to operate the drugstore chain’s virtual care services.

Sossong talked with Chief Healthcare Executive about children and mental health, the expansion of telehealth and the need to integrate behavioral health with primary care.

“Children’s behavioral health needs are not just staggering but they are growing,” Sossong says. “Technology can play a big role in helping with that.” (The story continues after the video.)

The COVID-19 pandemic has added to the stress on younger kids and teens. Emergency department visits for young people between the ages of 12-17 rose 31%, while ED visits among kids 5-11 rose 24%.

Even before the emergence of COVID-19, many young people were struggling. Roughly one in six youths between the ages of 6 and 17 experience a mental health disorder, Sossong notes.

At the same time, healthcare leaders say many families have trouble finding help. Roughly 60% of U.S. counties don’t have a single practicing psychiatrist.

There’s also a dearth of therapists trained in working with children, Sossong notes. Only 4,000 of the nation’s more than 100,000 psychologists are specifically trained to treat children and adolescents. Rural areas in particular have a dearth of trained clinicians in behavioral health.

“There’s a staggering need in terms of an absolute shortage,” Sossong says.

“Telemedicine can do a lot to alleviate that relative mis-distribution and really bring healthcare out to the rural areas and the areas of the country that are less well resourced.”

Children and teens have experienced much of the same stress and anxiety as adults in the pandemic, Sossong says.

“I think what’s important to remember is the lockdowns, school closures, the social isolation, has really changed the way children are developing and acquiring social and interpersonal skills,” he says.

“Developmentally it has had a profound effect on children just like adults,” he adds. “And kids express their distress in a lot of ways, but in very different ways than adults.”

Ensuring access

While the lack of providers is a problem, healthcare leaders note hurdles to expanding virtual care options, including behavioral health. Some families lack high-speed internet, and a federal report this year found disparities in access to video telehealth services among members of minority groups and those with lower incomes.

“We don’t want to limit the provision of care to those with high-speed internet or fancy mobile devices,” Sossong says. “We want to make sure those children are getting care, regardless of their socioeconomic status.”

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Amwell’s platform is “technology agnostic,” Sossong says, and the company can provide care through through mobile devices, tablets, computers, kiosks.

To address some of those challenges, many in the healthcare industry are urging the need to integrate behavioral health with primary care. Several healthcare groups, including the American Medical Association and the American Academy of Family Physicians, have formed the BHI Collaborative to promote combining behavioral health with physical health. Sossong says he supports that effort wholeheartedly.

While some families have a difficult time finding a psychiatrist or a therapist, many kids see pediatricians regularly, and that can be an avenue to spotting mental health needs.

“That’s a good place to start,” he says.

“Pediatricians are really well suited to address the needs of the child and work with the family and make the appropriate referral,” Sossong says.

However, it’s important to see that the referral actually leads to care, as some families don’t actually make appointments.

Amwell is focused on connecting kids to behavioral health, he says.

“We make it easy to connect children, adolescents and teens to telebehavioral health services and allowing for a seamless integration between the in-person encounter and the telemedicine encounter, recognizing that a team-based approach really does produce superior outcomes, Sossong says.

Telemedicine can also help families of children with special needs who find it difficult to get to appointments. “The thought of having a child who has a developmental disorder or problems with getting ready and going out with family, you could see how telemedicine could be a very easy solution to a number of those problems,” Sossong says.

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Setting the stage for the future

Telehealth usage has surged since the COVID-19 pandemic, especially as the government relaxed restrictions on providers to expand telehealth services.

Needless to say, Sossong is optimistic about telemedicine’s potential in the coming years.

“Telemedicine has been right around the corner for decades, and suddenly it came, and now people are saying, what’s next,” Sossong says. “

“I think we’re still seeing the benefit and we have yet to recognize the full potential of telemedicine in healthcare,” he explains. “I think that, not just in behavioral healthcare, but in all aspects of healthcare, thinking about an integrated sort of approach, a hybrid approach where you have an extended treatment team, you have many options available. I’m very excited about it and I’m excited to see what’s next.”

Like many in the telehealth field and across healthcare, Sossong is anxious to see Washington approve telehealth reforms beyond the pandemic, since federal waivers are tied to the COVID-19 Public Health Emergency. President Biden and Congress approved a provision in the 2022 spending package that would allow telehealth waivers to continue about five months after the end of the public health emergency.

The U.S. House of Representatives approved a bill in July that would allow Medicare patients to use telehealth through 2024; the bill passed with a 416-12 vote, winning unusually strong bipartisan support in a divided Congress. The Senate must still approve the measure.

Sossong says he’s cautiously optimistic about telehealth reforms.

“What happens in the next 12 months is going to set the stage for the next 10 years of treatment,” he says.