It has been said, in nearly every way possible, that 2020 was a brutally tough year. While the year definitely presented many challenges, there were also many learning opportunities.
One area that emerged was the increased acceptance and use of telemedicine. Prior to COVID-19, many employers offered telemedicine to employees as part of their benefits plan. However, in the wake of the pandemic, nearly half of all employers have started expanding their health-care benefits, especially in this area. In response, telemedicine has not only grown in volume, but it has also grown in scope — particularly in the area of mental health.
Over and above the convenience and safety that telemedicine helped provide worldwide during the last year, an unexpected increase for mental health support also arose. Mental health in the United States has always come with unique challenges and stigmas — many don’t know how to ask for help; others don’t want family members, friends and co-workers to view them as weak, unconsciously yielding to the misguided cultural idea that asking for help lacks strength. The good news is that telemedicine appears to be chipping away at these roadblocks by offering accessibility and connectivity while also slowly removing the stigma associated with reaching out for support.
In a 2016 study published by The Lancet Psychiatry, it was reported that “For the U.S., every $1 invested in expanded treatment for depression and anxiety leads to a return of $4 in better health and enhanced labor participation and productivity.” Further, improved mental health within society offers more than just economic rewards and improved personal well-being: a 2011 study conducted over the span of 19 countries produced data that revealed that mental illness increased the likelihood of divorce by up to 80%.
Since the pandemic, the number of people seeking assistance with depression has skyrocketed. Whether struggling to cope with the stress of the pandemic in general, dealing with illness within one’s familial and friend circle, adjusting to a new work-home balance, or pushing oneself to quickly learn new ways to accomplish one’s workload, across the board, individuals have indicated that they feel burnt out, especially when it comes to work. Indeed, the Center for Infectious Disease Research and Policy reported that COVID-19 has tripled the rate of depression in U.S. adults throughout all demographic groups. As unfortunate as that is, the spotlight and a more welcoming perspective on mental health care may prove to provide society with a better path in the future.
“From the ashes of a pandemic and economic crisis may rise a mental health movement that could draw the focus of businesses looking to improve productivity. They will realize a workforce with improved mental health can lead to increased productivity, a better company culture and progress at every level.”
According the FAIR Health’s recent white paper, “The Impact of COVID-19 on Pediatric Mental Health,” for the age group 13-18 in April 2020, “claim lines for generalized anxiety disorder increased 93.6 percent as a percentage of all medical claim lines over April 2019, while major depressive disorder claim lines increased 83.9 percent and adjustment disorder claim lines 89.7 percent.” Furthermore, as it regards overdoses for the 13-18 age group, the FAIR Health’s white paper finds that “there was an increase of 94.91 percent as a percentage of all medical claim lines in March 2020 and 119.31 percent in April 2020 over the same months the year before. Claim lines for substance use disorders also increased as a percentage of all medical claim lines in March (64.64 percent) and April (62.69 percent) 2020 as compared to their corresponding months in 2019.”
Teladoc’s October 2020 study release noted that mental health virtual care visits went up 79% for men and 75% for women since January of that year. This rise in virtual care usage goes far beyond convenience, safety and affordable access. This confidential and accessible service provides tools and support previously inaccessible and shunned. While virtual care will never replace the need for in-person care, it can act as a life preserver for those in need and a springboard to more in-depth services for those who might never have reached out if it were not for the instant and convenient access of telemedicine.
The ups and downs of 2020 certainly provided an environment in which the entire population collectively felt stuck, vulnerable, isolated and a level of stress in a way many of us have never experienced. And maybe it is that collective experience that has allowed us as a society to break through the barrier of accepting the positives of mental health support. It seems, at the very least, the notion of seeking help for mental health as a weakness is slowly and steadily fading.
If society continues to take a positive path of changing the mindset on mental health care, it could have wide sweeping effects. The future is bright for the telemedicine segment — and individuals, businesses and society as a whole will be better off for it. From the ashes of a pandemic and economic crisis may rise a mental health movement that could draw the focus of businesses looking to improve productivity. They will realize a workforce with improved mental health can lead to increased productivity, a better company culture and progress at every level.
In short, the Greek philosopher Thales’s view on health — “A sound mind in a sound body” — held true in 2020, which has shown businesses firsthand that a workforce of sound minds helps produce a business with a sound body. And, at the end of the day, no matter how you look at it, a more accepting outlook on mental health care is definitely a good thing.
For the last 10 years, Carlson’s company, Benefit Intelligence, has worked with GLJ Benefit Consultants to help provide ALA member firms with access to valuable benefits, including Teladoc’s no-copay telemedicine program and SupportLinc’s employee assistance program.
In a year of many changes, we examine which ones will have staying power.
All of us have been touched personally and professionally by COVID-19. As the world passes the one-year mark of when everything we knew shifted, legal organizations are grappling with an unprecedented mix of challenges as they strive for profitability while protecting the health of employees and clients.
The foremost challenge is the need to adjust to the work-from-home paradigm. “This was the first time many firms faced the need for remote staffing,” says ALA President Debra Elsbury, CLM, Firm Administrator at Threlkeld Stevenson. How well they have met that need, she adds, depends largely on their level of preparedness prior to the arrival of the pandemic. “Law firms utilizing the traditional business model with a very structured environment found themselves scrambling. Those that had already embraced technological change were able to hit the ground running and had fewer negative impacts on their business model.”
Larger law firms would seem to have a leg up on these matters, given their typically greater technological change. “Big firms were better situated in many ways to handle the change to remote work because most already had geographically dispersed workforces and tried and tested infrastructure, policies and practices for working remotely,” says Brie Leung, Director of Strategy and Marketing at Much Shelist, P.C. “But an organization such as ours — we have around 200 employees, with two offices in Chicago and Newport Beach, California — is very accustomed to doing things in person, just walking down the hall to get what we need. And so changing how we work meant much more than simply changing our technology and processes. A tremendous focus has been placed on internal communication, culture and community efforts, virtual wellness programs and creative client outreach programs.”
Hurdles remain even for those law firms able to pivot on a technological pin. A case in point is Galloway, Johnson, Tompkins, Burr & Smith. While the firm was able to leverage its earlier adoption of cloud computing following Hurricane Katrina in 2006, the pandemic still created difficulties when it came to monitoring staff productivity.
“When our legal assistants, paralegals and administrative folks are not in the office, it’s more difficult to make sure they’re doing what they’re supposed to be doing during the workday,” says firm Chief Financial Officer A. Ray Lightell, Jr., CLM, CPA.
While attorneys can be monitored in terms of billable hours, administrative staff members require regular engagements with supervisors via Zoom or conference call. That level of monitoring, though, is not without drawback: costly supervisory time. While software may be able to help track work hours, Lightell feels the effort to manage remotely remains a work in progress. “Honestly, I don’t think any of us are managing the administrative staff well enough,” he says.
“Law firms utilizing the traditional business model with a very structured environment found themselves scrambling. Those that had already embraced technological change were able to hit the ground running and had fewer negative impacts on their business model.”
Firms with scattered locations face another problem: dealing with a confusing patchwork of state, county and municipal remote working regulations. Galloway, for example, has 12 offices in seven states. In Louisiana, the firm’s offices in Lafayette and New Orleans are subject to different regulations affecting both the law firm and the courts. Adding to the confusion is the fact that federal courts tend to follow what the federal judiciary’s administrative agency in Washington, D.C., advises, while state courts follow their own state regulations.
Such patchwork regulations can upset clients. “We may be working with the same client in seven or eight locations,” says Lightell. “In some places we can go to court and trial while in others we may need to do everything by video. Clients want us to be moving cases along, and sometimes we just can’t.” Thankfully, most people are understanding. “Most clients are very receptive to the challenges we have to deal with because they’re dealing with the same things on their end.”
Because courts are conducting hearings — and even some trials — virtually, there’s a whole new dynamic to trial preparation and presentation, notes Scott Brennan, Chief Executive Officer of Lexicon, a practice management provider. “Now, attorneys have to prepare their clients and witnesses to act and present themselves in a respectful manner sitting behind a keyboard and monitor as if they were in an actual courtroom.”
As the legal community enters its second year of the pandemic, law firms will continue to grapple with a changed environment, taking actions such as reducing their real estate footprint, improving communications for remote locations, reducing staff inefficiencies, and dealing with changing regulations.
Technology will doubtlessly play a role in these efforts. And while a mix of bits and bytes and equipment cables may seem impersonal, technology can, paradoxically, bring people closer together. Take, for example, RatnerPrestia, PC, where Chief Operating Officer Barbara A. Foley, CLM, found herself spending a large amount of time every day interacting with people on Zoom calls, making sure she understood their issues and helping them adjust to the new norm.
Technology became the key to human bonding. “Prior to the pandemic I could not be in all of our offices at the same time, so I did not have the opportunity to walk around and see people the way that I could see them with Zoom,” says Foley. “When you see people on camera every day you get to know them in a much different way. You see their surroundings, their children, their pets and, of course, their challenges.”
“We may be working with the same client in seven or eight locations. In some places we can go to court and trial while in others we may need to do everything by video. Clients want us to be moving cases along, and sometimes we just can’t.”
Foley also used technology to launch a daily virtual coffee klatch to get all employees engaged in the early morning. “While some people are naturally motivated when working remotely, others have issues getting started,” says Foley. “The morning meeting forces everyone to get dressed and get in front of the camera. Our discussions are not necessarily work-related but proceed as if we were standing in our kitchens at our respective offices. This has been a big help in keeping the whole group together.” She says other activities included a virtual Halloween party, a Thanksgiving luncheon, happy hours and a virtual holiday lunch complete with entertainment. Foley expects the Zoom sessions and the morning coffee klatch to continue once the pandemic is over.
The unexpected result was a deeper understanding of employees. “I got to know all of our people — attorneys, staff, paralegals — much more intimately and personally than I did before,” says Foley. “That personalization has led to an increase in morale and motivation.”
As legal managers grapple with the challenges posed in the last year, many believe that practices required by the pandemic will still prevail remain in a post-pandemic world.
“I have people who have requested to work from home permanently, and I have approved those requests,” says Foley. “I have other folks who can't wait to get back to the office, and I have some that want to work in a hybrid model — that’s also fine.” Foley believes that trusting employees and giving them tools they need to succeed is the key.
The dark cloud of the pandemic, then, may have a silver lining. “The pandemic really forced law firms to figure some things out that have been a long time coming, and in a way that will actually be beneficial to our long-term success as organizations,” says Leung. “The pandemic is making us into stronger organizations for the future and really shining a light on how we can and should embrace new ways to help our people and our clients thrive.”
Don’t forget to check out our Online Community forum exclusively dedicated to COVID-19, as well — members from all over North America are sharing their insights about how to handle this unique situation.
