Web Barriers To Accessing Mental Health Services

By Felix Menges

Websites are an important tool for individuals to learn about mental health services available and how to contact service providers to seek help. Frequently, these websites only provide a phone number (and sometimes an email, if you’re lucky) for prospective patients to schedule an appointment. However, by only offering these options to schedule an appointment, your website may be unintentionally creating barriers for people to access your service.

As an autistic person, there have been countless times when I’ve put off scheduling appointments for weeks or even months because of the anxiety from having to make a phone call, and I’m not alone in this experience. Certain disabilities, such as autism, social anxiety, auditory processing disorder, speech impairments, and cognitive disabilities, can make placing phone calls difficult if not impossible. If you’re a healthcare provider trying to serve these groups, and the only option you provide for scheduling an appointment is to call, then you may be creating a barrier that is counterproductive to your mission.

Phone calls provide an easy way for service providers to schedule appointments, but they should not be used alone to access your services. Providing multiple ways to contact, such as phone, email, forms, or digital calendar tools for scheduling, can reduce barriers and make your service more accessible. While this guide specifically focuses on mental health service providers, many of the insights here can be applied to other industries to make accessing your services more accessible.

How Can Mental Health Service Providers Make Scheduling Accessible?

At the bare minimum, Mental health service providers should provide a phone number and email for people to contact to schedule an appointment. These days, there are also numerous software that make scheduling easier, such as CERTIFY Health and NextGen, which allow patients to schedule appointments 24/7 online on their own. But if the cost of those services is an issue, it may be cheaper to build your own form to schedule appointments or request information.

Forms offer benefits that can make scheduling more accessible and streamline the appointment-making process. If built right, a form may make reaching out for help less daunting because it allows patients to contact you whenever they want, without any social interaction. Forms can be built into your website from scratch using code, or they can be embedded from third-party providers.

It’s important to note that not all third-party form providers are HIPAA compliant and may require additional steps to ensure privacy. For example, Google Forms is not HIPAA compliant by default, but can become compliant after signing a Business Associate Amendment (BAA) with Google. If privacy remains a concern, you could use your form as a way to schedule initial screening calls or follow-up emails, where you can get your patients’ more sensitive information on a secure channel.

When designing forms, there are best practices to ensure that everyone can access, understand, and use your form. The following are some tips to follow when making your forms.

Minimize user input

The less work a user has to do, the more likely they are to complete your form.

Use radio buttons or checkboxes for questions that have common answers (see following example)
Try to avoid short-answer questions if possible, since it’s easier for a user to check a box than write things down
Include an “other” option with the ability to write down something in case your selection options don’t have what the person needs

1. Select one of the options in the example radio button question

Option 1 Option 2 Option 3

2. Choose one or more options in the example checkbox question

Option 1 Option 2 Option 3

Make the form as simple as possible

Use simple and plain language to provide clear user instructions
Make sure required fields are marked as such using a symbol like an asterisk (*) or writing required in parentheses

If using a symbol, ensure there is a note on the form informing users that the symbol indicates required

Provide a progress indicator (i.e., page 1 out of 3), so users know how long the form is
Avoid using too many colors and make sure there is high contrast between the text and background color to enhance readability
- You can use online tools like Coolors to check for color contrast

Provide examples

If users need to write something, provide examples, especially if they need to be formatted in a certain way (i.e., (XXX) XXX-XXXX for phone numbers).

Some forms also have the option to automatically format certain answers.

Website information

Make it clear what services you provide and who you serve (i.e., children, teens, adults, etc.)
Provide instructions on how people can make appointments, i.e., “fill out this form to schedule an appointment today”

Multiple devices and WCAG guidelines

The vast majority of people visit websites using their mobile devices, so it’s essential to test your forms and websites work on a variety of devices, including phones, computers, and tablets.

Additionally, your form and website should follow Web Content Accessibility Guidelines (WCAG) to ensure disabled users, such as those with vision or mobility impairments, can access your content using accessibility tools like screen readers or switch devices.

The Web Accessibility Initiative provides a list of web accessibility tools to help you determine if your form or website meets accessibility guidelines.

What To Do If Your Only Option Is To Call?

While it would be great if all mental health service providers could implement the suggestions previously mentioned in this guide, in reality, you are likely to encounter situations where calling is the only option.

If you have a disability that makes making phone calls difficult, this can make skipping seeking help tempting, but there are a few things you can do to help make the task less of a burden.

Ask family or friends to make the call for you

In the past, this was the method I used the most whenever I needed to make a call to schedule an appointment, but wasn’t feeling up to it. Getting someone else to make the call for you can make the process less stressful. However, many times it isn’t feasible if there’s no one available to make the call for you, or there’s no one you trust to make the call.

Create a script of what you want to say

Preparing and practicing a script of what you want to say beforehand can help make the phone call less overwhelming and help ensure that you don’t forget to mention anything during your call. Additionally, even if you can get someone to make the phone call for you, providing a script or notes of what you want them to say can help ensure your needs get met.

According to the Substance Abuse and Mental Health Services Administration, when scheduling an appointment, you generally need to provide the following information:

Your name
Phone number
Age
Your insurance, or if you’re paying out of the pocket, ask how much the service costs
What you’re seeking help for (i.e., depression, anxiety, grief, etc.)
What you want to get out of treatment (i.e., coping skills, emotional regulation, mindfulness, etc.)
Can they prescribe medication if you think you need it
If you want telehealth or in-person visits
The days and times you’re available to meet
If they have any assistance programs or public transportation nearby, if you need transportation assistance
If they can provide the accommodations you need

Use real-time text (RTT) when making the call

If you still think it’ll be difficult for you to talk on the phone after making a script, you can consider using real-time text when making the phone call. Real-time text is an accessibility tool built into both Android and Apple phones that allows users to communicate using text during a phone call. This feature was designed for users with speech or hearing difficulties, but can also be helpful for people who have less anxiety texting compared to talking.