How the infrastructure bill could change mental health care

Since the coronavirus crisis began, studies show a nearly four-fold increase in anxiety and depression, and drug overdoses have skyrocketed. Providers say record numbers of patients are now seeking mental health services – and more than 40 percent of these visits take place virtually with telehealth. For these patients, broadband has become a literal lifeline. 

At NAMI Delaware, we work with individuals and families affected by mental illness, offering support, education and advocacy statewide. We have seen firsthand the devastating impact the pandemic has had in the First State, and we expect a continued rise in need for mental health support services for many months and years to come. Now, more than ever, equitable access to virtual mental health services is an essential part of our collective recovery. 

But for many in need of mental health services, telehealth access is out of reach. More than 40 percent of adults earning less than $30,000 a year - a segment at much higher risk of depression and other mental health challenges - lack home broadband.

That’s why the infrastructure debate underway in Congress could have huge repercussions for how we treat mental illness and drug addiction here in Delaware and across the country. The Senate will soon vote on a bipartisan plan to spend $40 billion  to close broadband access gaps in rural areas, and to commit an additional $14 billion to help connect the far larger group of urban residents who have high-speed service available but still aren’t online.  

This broadband plan would be a game-changer for Delaware, where 98 percent of homes are wired for the internet, but just 75 percent subscribe to the broadband on their doorsteps.   This “adoption gap” reflects a number of factors, including the financial barriers many families face in budgeting for home computer costs and monthly internet service fees, as well as lack of awareness about available support resources and digital literacy training.

Broadband providers have long offered discount programs to low-income subscribers, some of whom get online for as little as $10 a month.  And these programs show huge promise - they’ve already connected more than 14 million Americans.  

However, even when broadband is available for free - for example, through the Connect Delaware partnership aimed at low-income students – many eligible families still don’t sign up.  Research points to a range of reasons: some don’t know about the programs, don’t trust offers that may sound “too good to be true,” or face structural challenges like language barriers or uncertain housing situations. An estimated 32 million Americans also lack basic digital skills.

Promisingly, the bipartisan infrastructure agreement includes unprecedented funding to knock down this diverse set of barriers.

Most significant is a long-term extension of the successful Emergency Broadband Benefit program, which launched in May and offers low-income families up to $50 a month to buy home broadband service. Nearly 4 million families have already signed up, and this new funding will allow the program to serve millions more for years to come.

This bill also commits new resources to digital skills training and inclusive outreach programs aimed at helping more eligible families take advantage of these offers.  Surveys show having someone to walk unconnected adults step-by-step through the sign-up process would make a huge difference in getting more online.

And when it comes to telehealth access, not only does closing the digital divide mean more equitable access to services, it could also mean more effective access, too.  Data from mental health providers suggest no-show rates plummet when patients are seen virtually as opposed to in person.  

More widespread access to telehealth will also help smooth local provider shortages in understaffed communities.  Consider that an estimated 80 million Americans live in an area with a mental health provider shortage; empowering them to instantly connect with caregivers hours away could dramatically improve outcomes and save lives.

The bipartisan infrastructure bill represents the boldest federal commitment ever attempted to ensure every Delawarean can share in the benefits of home broadband and telehealth access. When all Delaware communities have equitable access to these lifesaving resources, the mental health and wellness of our state can be addressed more comprehensively than ever before.