Monday, February 5, 2024

Telemental Health Availability Varies Across U.S., but Robust Overall

A large majority of mental health treatment facilities in the U.S. have continued to offer telehealth services since the pandemic, according to the results of a survey published in JAMA Health Forum. While telehealth availability varied by geographic location and facility ownership (public vs. private), there were no significant differences in availability based on patient characteristics.

The survey findings “are encouraging insofar as we did not observe a systematic bias in which available services differed based on perceived race and ethnicity of the client, stated clinical condition of the client, or county-level sociodemographic characteristics,” wrote Jonathan Cantor, Ph.D., of the RAND Corporation in Santa Monica, Calif., and colleagues. “However, our findings indicate that a prospective client may face several hurdles finding a facility that offers comprehensive telehealth services.”

The researchers posed as prospective new patients and randomly called 1,938 mental health facilities between December 2022 and March 2023. The facilities included psychiatric hospitals, Veterans Affairs medical centers, certified community behavioral health clinics, outpatient facilities, and more. Using a standardized script, they inquired about what telehealth services were available and when an appointment could be made. To identify potential biases from staff, the callers were randomly given a specific condition –major depression, generalized anxiety disorder, or schizophrenia—as well as an identifiable Black, White, or Hispanic name.

The researchers received responses from 1,404 facilities, of which 1,221 (87%) were accepting new patients. Of this group, 980 provided some telehealth services:

  • 937 facilities (97%) offered counseling via telehealth.
  • 726 facilities (77%) offered medication management via telehealth.
  • 626 facilities (69%) offered diagnostic services via telehealth.

Overall, compared with public mental health facilities, private for-profit facilities were 1.75 times as likely to offer mental telehealth services, while private nonprofit facilities were 2.20 times as likely.

Service availability also varied by state; less than half of the facilities contacted in Mississippi and South Carolina provided telehealth while every facility contacted in Delaware, Maine, New Mexico, and Oregon did. Median wait times also varied greatly, from four days in North Carolina to 75 days in Maine. Across the whole sample, however, there was no evidence to suggest facilities were biased against individuals with a specific condition or perceived race/ethnicity.

While the researchers said the overall findings were encouraging, they were concerned with the significant number of facilities that did not respond to multiple phone call attempts.

To read more about this topic, see the Psychiatric News article “North Carolina’s Telepsychiatry Program Expands Reach, Saves on Costs.”

(Image: Getty Images/iStock/FatCamera)

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