Pandemic drives use of telehealth for mental health care: Researchers expect mental health counseling online will endure beyond the pandemic, call for caution to improve disparities in telehealth access

The COVID-19 pandemic has permanently increased the delivery of mental health counseling via telehealth, according to new research from Oregon Health & Science University.

The retrospective analysis was published today in the April issue of the journal health matters,

Lead author Zhen Zhu, assistant professor of medicine (general internal medicine and geriatrics) at the OHSU School of Medicine, said, “Our study shows that telehealth services for mental health counseling have expanded significantly and are likely to remain so. ” “Future applications of tele-mental health should really be focused on understanding the population, context, and disease conditions most conducive to this method.”

Zhu and co-authors used a non-governmental claims clearinghouse to analyze data from 2016–18 and compare it with the pandemic onset period from March to December 2020, which totaled 101.7 million outpatient mental health visits. was organized.

They found that in-person mental health visits initially declined 21.9% during the early stages of the pandemic, despite the onset of the stress-inducing epidemic. Mental health visits made a quick return by the end of the study period in December 2020, however, with almost half of them – 47.9% – transitioning to telehealth.

Researchers explored differences in telehealth use between clinical conditions. For example, people seen for schizophrenia were less likely to use personal visits, while those with anxiety and fear-related disorders used telehealth more and more.

The authors cite additional research revealing that older adults, black and Hispanic people, people living alone, and people with low incomes are less likely to access mental health counseling online.

“Telemedicine is often talked about as the next frontier of health care delivery,” Zhu said. “Nevertheless, the evidence in our paper suggests a reduction among some groups that face barriers to telehealth.”

Researchers expect patients to continue to make substantial use of telehealth in the coming years.

Telehealth is uniquely suited to mental health services, they write. Even before the pandemic, earlier studies had raised the prospect of improving access to care for the 119 million Americans who live in areas defined as lacking health professionals. In addition, studies have shown a higher satisfaction among patients who do not necessarily require a detailed personal physical examination or laboratory tests that are often required for medical or surgical care.

The authors end with a cautionary note:

“While reducing regulatory and payment barriers can improve access to care, reliance on telehealth can exacerbate existing health care inequalities or worsen care outcomes for other populations, particularly if access to broadband Internet is limited. areas that have limited or low income or medically unavailable vulnerable populations,” they write. “Future research is needed to understand how telehealth modalities lead to increased overall demand for mental health care. can improve equitable access.”

In addition to Zhu, co-authors included OHSU’s Rene Myers, MPH, John McConnell, PhD, and Ximena Lavender, MD; and Sunny C. Lin, Ph.D., now of Washington University in St. Louis.

The research was supported by the National Institutes of Mental Health’s Institute of Mental Health, grant award numbers 1K08MH123624, R01MH122199 and R01MH123416. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Material provided by Oregon Health and Science University, Original written by Eric Robinson. Note: Content can be edited for style and length.

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