Are House Calls Returning for Mental Health Services?

You turn on an old black-and-white movie featuring a child who becomes ill and bedridden. As a medical professional, you know what comes next: The weakened individual will invariably be visited by their doctor. There is no drive to the doctor’s office and no waiting in the waiting room. Instead, little Billy or Sally rests comfortably in their own bed, and the doctor — black bag and all — comes by for a simple house call.

It’s a practice as dated as the black-and-white screen it’s captured on — a sign of a bygone era. But today, suddenly, old is new again.

Across the country, more doctors are abandoning the traditional clinic/hospital model and returning to the more hands-on approach of in-home visits. They do so because they see the opportunity it provides to improve patient care. As in-home visits increase, the industry as a whole is starting to realize the potential cost savings this shift presents.

According to data appearing in the New York Times, one-third of the Medicare department’s budget is spent on care for chronically ill individuals during the last two years of their life. Chief among these expenses are hospitalizations that cost $12,000 per stay on average. House calls made by doctors reduce the need for such hospitalizations and allow patients to maintain some form of independence later in life. This, in turn, then reduces the costs incurred for nursing home solutions.

In addition, a 2014 study found that frail, elderly individuals serviced by house calls instead of conventional clinics or hospitals saved Medicare $4,200 per person annually, providing ample motivation to support the program.

In-Home Visits and Mental Health Professionals

As in-home care visits increase in popularity across the field, will the paradigm shift encompass mental health professionals as well?

In some cases, that transformation has already begun, and those taking part are seeing the same benefits as their counterparts in other fields.

In instances where in-home treatment practices have been adopted, patients with mental health conditions — including schizophrenia, psychosis and bipolar disorder — are able to receive the care they need for their conditions from in-home mental health professionals in a comfortable environment. In many cases, these patients saw little benefit from traditional hospitalization.

While patients benefit from improved outcomes and additional independence, there are benefits to the system as well. In-home visits mean fewer patients are sent to inpatient psychiatric hospitals, and fewer patients will appear in homeless shelters or live on the streets.

 

North Carolina is one section of the country where in-home patient visits by mental health professionals are gaining steam. In the Orange, Chatham and Durham areas, the 13-member Assertive Community Treatment team at the University of North Carolina serves more than 100 clients. A second team also works to provide service in Wake County. And as the trend grows in popularity, more and more mental health doctors can set their sights on traveling to see their patients — little black bag and all.