Telehealth visits accounted for nearly two-thirds of all mental health visits by patients enrolled in private insurance plans in the early months of the COVID-19 pandemic, according to a report published Tuesday in Psychiatric Services in Advance.
However, telehealth use for mental health services from April to June 2020 was lower in rural areas compared with urban areas, and lower among those over 65 years of age compared with those 24 to 35 years of age.
“Telehealth-based mental health services increased overall, but future work might examine why uptake was lower in rural areas and among older individuals and how broadband infrastructure and digital literacy may affect telehealth use,” wrote lead author Jiani Yu, Ph.D., of Weill Cornell Medical and colleagues.
The researchers analyzed roughly 25 million separate mental health claims submitted between January and June 2020 in a national data set of commercial enrollees from FAIR Health, a nonprofit organization managing a database of more than 33 billion privately billed health insurance claims. They calculated telehealth use rates for different conditions as a percentage of all mental health services.
The researchers found that the telehealth use rate for all mental health services increased from 2.2% in January 2020 to 65.2% in April 2020, remaining stable at 65.6% in June 2020. By comparison, telehealth rates for acute respiratory diseases and infections (the service category with the next-highest telehealth use rate behind mental health) decreased from 44.3% to 28.1% from April to June 2020.
Services for generalized anxiety disorder made up the largest share of mental health telehealth services (28.4%), followed by major depressive disorder (23.6%), and adjustment disorder (18.6%).
The changes in the rates of telehealth use for mental health conditions early in the pandemic varied according to where the patients lived, the authors noted. In April 2020, telehealth use for mental health was similar in urban (65.6%) and rural (60.5%) areas, but by June 2020, telehealth use decreased to 49.6% in rural areas while urban use remained high at 66.8%.
“As mental health digital interventions continue to proliferate, new evidence on the cost-effectiveness of telehealth may determine whether mental health services will still primarily be delivered remotely,” the researchers wrote.
For related information, see the Psychiatric News article “Will Telehealth Rules Change After Pandemic? Prepare Now.”