Online therapy is here to stay. And while people rave that it has brought mental healthcare to the fingertips of Americans, many clients still face barriers that prevent them from accessing these virtual care options.
So has this trend actually improved access for marginalized communities, or is it just widening the digital divide? Keep reading to learn who’s using teletherapy and whether it’s a real benefit for underserved populations.
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What is the ‘Digital Divide’?
The digital divide refers to the difficulty for certain populations to use the Internet. It is related to the availability of and access to the hardware required to engage in activities like telehealth, such as computers, laptops, tablets, and smartphones.
Poor broadband access and low digital literacy are additional factors that widen the gap. Even if they have access to a computer, more than 50 million Americans do not know how to use it. Those who lack digital literacy tend to be older, less educated, and black or Hispanic. Poor broadband access is most pronounced in states with a high percentage of rural residents, such as Alaska, Montana, and Nebraska.
The fact that 79% of Americans use the internet leaves out the 21% – most often people belonging to communities of color – who are left behind. Some other recent statistics about access to technology include:
Lack of access to desktop and laptop computers
Only 69% of Black Americans and 67% of Hispanic Americans own a desktop or laptop computer.
Lack of access to smartphones
Most Americans today – 97% – own a cellphone of some kind. But only 61% of adults aged 65 and older own a smartphone.
Lack of access to broadband
Eight in ten White Americans have a broadband connection at home, while only 71% of Black Americans and 65% of Hispanic Americans can say the same.
Additionally, many Americans living in poverty own smartphones but do not have broadband in their homes. Twenty-seven percent of people with annual incomes under $30,000 are ‘smartphone reliant,’ meaning they lack traditional home broadband services.
How Online Therapy Benefits Marginalized Groups
In the past, teletherapy has most often been used by people who have limited access to services, lack of transportation, or mobility issues. More recently, in response to the necessary transition to online therapy due to the pandemic, teletherapy has demonstrated that it can benefit several marginalized groups.
Online therapy can be particularly valuable for older adults who may have difficulty getting to a therapist’s office. Online therapy means seniors don’t have to leave their homes for the session, eliminating transportation concerns. This is especially valuable for older adults who no longer drive or rely on public transportation.
In addition, seniors who have compromised immune systems or other medical issues can reduce their direct contact with others by attending therapy sessions virtually instead of in person.
Barriers: Technological issues are the most common barrier for older adults. A recent study found that only 7 in 10 adults 65 and older report having a computer, smartphone, or tablet with internet access, versus virtually all younger adults. As a therapist, it’s important to remember that some older clients feel very comfortable navigating their computer or smartphone, but others may not feel so adept.
Mental health issues affect the LGBTQ community at a greater rate than the rest of the population. Many LGBTQ people struggle to find therapists they can trust. Many therapists are religious in some parts of the country, and LGBTQ clients may not feel that the therapist is the right fit. Online therapy allows LGBTQ clients to find a therapist who understands their unique challenges.
Barriers: Compromised online privacy is a major concern for members of the LGBTQ community engaging in online therapy. Since many LGBTQ people are often still choosing with whom they share their sexual orientation, therapists must ensure client data and virtual sessions are secure so sensitive information is never unintentionally revealed.
There’s no denying that therapy has been whitewashed and biased for a long time. Online therapy helps Black, Indigenous, and people of color (BIPOC) match with therapists who share their unique traits, values, and sensibilities. With physical location no longer a barrier, BIPOC clients can access culturally responsive therapists.
Barriers: While teletherapy has increased access to mental health services, it hasn’t done so to the extent many had hoped. The same problems that kept BIPOC from seeking care before the explosion of online therapy still exist. As a result, mental-health usage in the U.S. hasn’t changed as drastically as many advocates would have liked. Only 10% of the psychology workforce identifies as Black, Hispanic, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander, meaning there simply aren’t enough therapists of color to go around. Therapists need to acknowledge and understand why some BIPOC clients may not feel comfortable seeking help from them and work to address those issues in their own practices.
As many as 34% of veterans suffer from PTSD. Further, veterans are more likely to have experienced traumatic events that can lead to anxiety, depression, stress, and other mental health concerns. Therapy is vital for lessening the impact of these issues, and online options can make treatment more accessible to veterans.
Barriers: The suicide rate for veterans is 1.5 times higher than that of the general population. Online therapy may not be suitable for emergency situations involving threats of self-harm or harm to others due to the physical distance. Therapists should do their best to verify patient identities and locations if treating clients outside of their community.
People with Disabilities
Some people with disabilities may find it challenging to come into a physical office due to physical or mental conditions that prevent them from leaving home. Many counseling offices are in older buildings that are not wheelchair accessible or lack appropriate bathroom facilities for people with disabilities. Online therapy makes any physical or emotional barrier to in-person counseling a non-issue.
Barriers: Most online therapy platforms do not have custom features to ease healthcare communications for people who are deaf or blind or those with cognitive disabilities. Therapists may not be able to address all accessibility issues. However, they should research platforms with web accessibility standards that can accommodate people with disabilities.
People living in Rural and Remote Areas
Online therapy can give people living in rural and remote areas the help that they need without traveling far distances to reach a therapist. Even if there is a therapist nearby, people in small towns know each other, and clients often are not comfortable with others knowing they see a therapist. Online therapy removes geographic barriers and improves privacy for these clients.
Barriers: Access to computers, smartphones, and broadband is much less common in rural and remote areas. This limits their ability to access many online sites or to communicate online via video chat.
People with Addiction
Addiction therapy helps clients learn valuable skills and strategies to reclaim their lives and repair potential damage that has been caused by a substance or behavioral addiction. Many people with addiction will benefit from the privacy and anonymity that online therapy offers. Some clients may feel more comfortable letting down their emotional barriers in the comfort of their homes.
Barriers: Online therapy sessions can sometimes lack the human connection of face-to-face conversation. If a client becomes highly emotional during a video session, there will be no one there to comfort that person through physical contact. This can leave some people with addiction feeling more isolated than ever, which is counterproductive for their healing.
As therapists build the online therapy system, which is likely here to stay, it’s essential to prioritize the needs of those who have been historically marginalized to ensure that mental health equity is achieved.
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