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Telehealth Continues to Play 'Outsized Role' in Mental Healthcare Delivery

Analysis  |  By John Commins  
   March 15, 2022

New research finds that 1-in-3 mental health consultations are done via telehealth.

The use of telehealth for outpatient services has ebbed and flowed with the COVID-19 epidemic, with the notable exception of mental health services.

That's according to a new study conducted by the Kaiser Family Foundation and Kaiser Health News and released Tuesday which found that mental health and substance abuse telehealth services accounted for 36% of all mental health visits nationwide between March and August 2021.

Before the pandemic, telehealth represented less than 1% of mental health and substance abuse outpatient care before the pandemic. During the pandemic's peak between March and August 2020, however, telehealth accounted for 40% of mental health and substance use outpatient visits and 11% of other visits.

"Since then, in-person care has returned and telehealth visits have dropped off to represent 5% of other outpatient care visits, those without a mental health or substance use claim in the March-August 2021 period," the study said. "However, telehealth use has remained strong for mental health and substance use treatment, still representing 36% of these outpatient visits."

At the pandemic's peak between March and April 2021, telehealth represented 13% of all outpatient visits. One year later, however, as in-person care resumed, telehealth use shrank to 8% between March and August 2021.

"While many continue to envision an expanded role for telehealth in the delivery of care following the pandemic, there remains considerable uncertainty in what services will be available, where and how providers will be able to practice, how benefits will be structured, and how providers will be paid," the researchers said.

Among the other findings in the study:

Telehealth use for mental health or substance use continues to grow as a share of all telehealth visits

Mental health and substance use visits are a growing share of both telehealth visits and outpatient visits overall, but the trend is much more pronounced for telehealth.

Between March-August 2021, 39% of telehealth outpatient visits were primarily for a mental health or substance use diagnosis compared to 24% a year earlier, and 11% two years earlier.

Among all outpatient visits (in-person and over telehealth), the share with a mental or substance use diagnosis grew from 4% in March-August 2019 to 8% during the pandemic, and has remained at 8% in March-August 2021.

The study authors said the usage reflects the tremendous increase in need for mental health services as a result of the pandemic, social distancing and economic turmoil.

Rural people are more likely to use telehealth for mental and substance use visits

More than half (55%) of rural patients relied on telehealth to receive outpatient mental health and substance use services between March and April 2021, compared to 35% in urban areas, a pattern that is sharply contrasted with other outpatient services, where there was a similar rate across urban and rural areas (5% v. 6%) 

Non-elderly adults regularly use telehealth to access mental health and substance use services

Between March-August 2020, outpatient telehealth for mental health and substance use were delivered at a similar rate among children and the elderly, and a slightly lower rate among non-elderly adults. In the most recent period, 58% of all mental health or substance use outpatient visits, and 62% of these visits performed via telehealth, were among people aged 19-64.

Telehealth use is significant across major mental health and substance use disorder conditions

Nearly one-third (29%) of outpatient visits for major mental and substance use conditions were delivered over telehealth during this period, including for substance use disorders such as opioid-related disorders (29%) and alcohol-related disorders (29%).

For mental health needs, more than one-in-three outpatient visits were delivered by telehealth (for example, 35% and 38% of outpatient visits were over telehealth for depression or anxiety, respectively).

“While many continue to envision an expanded role for telehealth in the delivery of care following the pandemic, there remains considerable uncertainty in what services will be available, where and how providers will be able to practice, how benefits will be structured, and how providers will be paid”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

Before the pandemic, telehealth represented less than 1% of mental health and substance abuse outpatient care before the pandemic.

During the pandemic's peak between March and August 2020, however, telehealth accounted for 40% of mental health and substance use outpatient visits and 11% of other visits.

Rural people are more likely to use telehealth for mental and substance use visits.

Non-elderly adults regularly use telehealth to access mental health and substance use services.

Telehealth use is significant across major mental health and substance use disorder conditions.


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