Tuesday, September 5, 2023

Patients Seeking Mental Health Care Want More Say in In-Person, Virtual Appointments

Nearly 1 in 3 adults receiving mental health treatment who were surveyed earlier this year said they don’t have much choice when it comes to whether they see their clinician in person or via telehealth. In part, this was because those surveyed reported that they did not see clinicians who offered both in-person and telehealth visits.

These were a few of the key takeaways from a report published this afternoon in Health Affairs.

“Although preferences regarding modality varied, with some preferring in-person care and others preferring telehealth for different types of behavioral health visits, the majority of interview participants wanted to have the choice,” wrote Jessica Sousa, M.S.W., M.P.H., of the RAND Corporation and colleagues.

The researchers conducted a nationally representative survey of 2,071 U.S. adults (average age 49 years, 74% White) in early 2023, including 571 who used behavioral health services in the prior year. They also completed in-depth interviews with 26 people with bipolar disorder or depression during this time. The participants were asked whether their clinicians were offering both in-person and telehealth visits for medication or individual therapy and how decisions about whether they saw the clinician in person or virtually were decided.

Recipients of individual therapy were about twice as likely to have telehealth visits (80%) as in-person visits (42%) during the prior year, the researchers found. Those seen for medication visits were about equally likely to receive telehealth visits (54%) as in-person visits (58%). About 24% of those seeking therapy said that the provider decided whether they were seen in person or via telehealth; for those seeking medication appointments, about 35% said the provider decided.

The respondents whose clinicians offered both in-person and telehealth appointments were also asked to rate their level of agreement with statements such as “When deciding whether visits would be in person or by telehealth, my provider considered my preference” and “Most of the time, I was able to get the type of visit (telehealth versus in-person) that I preferred.”

Nearly 55% of the survey respondents agreed that their clinician considered their visit preference when deciding whether to see the patient in person or by telehealth; 68% agreed that they got the type of visit they preferred most of the time.

“Expanding telehealth is a laudable goal, given that it often is more convenient, increases access to care, and is effective for treating many behavioral health conditions. However, telehealth alone might not be sufficient,” Sousa and colleagues wrote. “For telehealth to achieve its potential to increase overall access to high-quality, patient-centered care, it is important to implement it in a manner that expands, rather than contracts, behavioral health access and options for patients.”

For related information, see the Psychiatric News article “The Hybrid Model: New Normal or Unstable Transition Phase?

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