How psychology can contribute to a strained healthcare system

A new report from the Danish Health Authority regarding the disease burden in Denmark emphasizes that the healthcare system faces significant challenges:

Lack of hospital beds, staff shortages, and a growing population of elderly citizens are just some of the problems adding additional pressure on an already challenged healthcare system.

The Danish Health Authority's report on Danish challenges shows that risk factors such as smoking, physical inactivity, and high alcohol consumption significantly contribute to the number of additional deaths.

Additionally, factors such as severe obesity, poor mental health, and high alcohol consumption also contribute significantly to extra somatic hospital admissions.

According to a group of researchers from the Department of Psychology at the University of Southern Denmark, there is a significant unused potential in psychology, as psychology can contribute with prevention initiatives, treatment for mental health issues, and behavioral changes to ensure a more healthy lifestyle.

- It would be advantageous to include more clinical health psychologists and digital health psychology treatments and prevention measures in the public healthcare system. By going digital, we end up with lower time consumption per patient without compromising quality, adds Robert Ahm, clinical health psychologist and PhD student researching online health psychology treatments.

The research group raises their voices in a debate article in Sundhedsmonitor because they believe they have something to offer in solving the challenges faced by the healthcare system.

- Part of the solution must involve thinking outside the box, working smarter, and considering unused potentials. In general, the healthcare system should pay more attention to the whole person by focusing on well-being and social health in addition to somatic and mental disorders, suggests Susanne S. Pedersen.

Here are three specific measures the research group believe can make a significant and positive difference:

1. Treat mental and somatic illnesses together

Behavior and well-being in everyday life have an impact on the risk of many common somatic diseases such as diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), and alcohol-related diseases.

According to the research group, by focusing on mental aspects such as anxiety and depression, and on behaviors such as smoking, it is potentially possible to:

• Prevent somatic diseases
• Treat the psychological challenges of these patients and support them in their treatment and daily life with a chronic illness
• Reduce the number of hospitalizations / decrease costs for society
• Improve the overall health and quality of life of Danes

Loneliness itself is a painful experience for individuals, but loneliness and social isolation can also have serious implications for our health.

- Loneliness and social isolation comprise risk factors for premature death, and individuals who feel lonely or socially isolated also have an increased risk of developing type 2 diabetes and various cardiovascular diseases. This is shown by both national and international studies, says Julie Christiansen.

Furthermore, there is evidence that social health also impacts disease prognosis and mortality among individuals who already have a chronic illness.

- However, it is important that patients with somatic illness and comorbid anxiety and depression are treated by psychologists who are not only knowledgeable about psychology but also the underlying somatic disease, says Susanne S. Pedersen and elaborates:

- We have heard that many patients – including patients with cardiac arrest or an implantable cardioverter-defibrillator (ICD) – become incredibly disappointed when they meet a psychologist who is not familiar with their condition, 

This can, according to her, lead to mismanagement, but also to patients having to explain what it actually means to have an ICD and experience shocks from the ICD, while what they need is an expert who is ready to provide help at a difficult time - both for the patient and their loved ones.

2. Patients are screened for anxiety and depression

The next focus of the research group is the importance of screening patients with somatic illness for anxiety and depression, and offering them treatment tailored to their challenges. This has the potential to save both time and money for society.

- For example, we know that depression in patients with heart disease serves as a barrier to lifestyle changes such as healthy living, quitting smoking, participating in rehabilitation, and generally following doctors' recommendations, including taking their medication, says Susanne S. Pedersen.

These patients also have a higher risk of dropping out of the workforce. Additionally, a patient with heart disease and depression costs society 33% more than a patient without depression.

- Therefore, it is important that we treat not only the 'heart' but also the 'mind' – and treat them together.

3. Digital solutions improve well-being and behavior

- Studies clearly show that online psychological treatments are effective. For example, we know that psychological treatment is effective in alleviating depression and anxiety. Since depression and anxiety also serve as barriers to changing habits, treating anxiety and depression can also contribute to a better and healthy lifestyle regarding alcohol, smoking, and exercise, explains Silke Behrendt. She is a psychologist and researcher specializing in problematic alcohol consumption.

These treatments used to exclusively take place in-person with the psychologist in his/her practice. However, with digitalization, the world of psychology is changing, and there are now alternatives in the form of internet-based treatments and prevention measures.

- For anxiety and depression, these internet-based treatments are generally as effective as when patients are physically present with the psychologist, says Silke Behrendt and elaborates: 

- It provides patients with enormous flexibility as they can access the treatment when they have the energy and desire to work on it.

Patients receive the treatment in their own homes through a computer or smartphone, at a time that suits them. This potentially makes it easier to integrate treatment or prevention measures into their daily routine and addresses geographical disparities in access to treatment.

Digital interventions for changing alcohol consumption can be particularly suitable because they ensure anonymity and thereby reduce the fear of stigmatization.

It can truly be a support in reducing potentially harmful alcohol intake, and digital interventions meet the widespread need to address these problems independently.