Telehealth Availability For Mental Healthcare Varies By State, Study Finds

Dive Brief:

• Telehealth availability for mental healthcare varies widely from state to state, suggesting some patients may face “several hurdles” when booking appointments for services, according to a study published Friday in JAMA Health Forum.
• The analysis, conducted by nonprofit research institute Rand Corporation, found less than half of mental health treatment facilities in Mississippi and South Carolina offered telehealth care, while all facilities contacted in Delaware, Maine, New Mexico and Oregon did. 
• Researchers were also unable to reach one in five facilities when attempting to inquire about telehealth options, the study found. 

Dive Insight: 

Telehealth utilization skyrocketed during the COVID-19 pandemic, boosted by relaxed regulations that aimed to preserve access to care while patients and providers avoided unnecessary in-person contact.

Though virtual care use has fallen back to nearly pre-pandemic levels in many fields of medicine, mental healthcare has remained elevated, the JAMA study noted. Diagnoses for mental health conditions made up more than 66% of telehealth claim lines in November, according to a Fair Health tracker. 

Access challenges have long restricted how many people receive treatment for mental health conditions, and earlier research has shown telehealth could expand the number who receive care for common disorders.

In the latest study, researchers called nearly 2,000 facilities to ask about their current telehealth availability. They posed as prospective clients looking for care for major depressive disorder, generalized anxiety disorder or schizophrenia. They also randomized the names used, so they could determine if perceptions of race or gender affected the results.

Though they repeatedly called some clinics, the team could only reach about 1,400 facilities. 

“We tried to replicate the experience of a typical client seeking specialty care from a mental health treatment facility in the U.S.,” Jonathan Cantor, the study’s lead author and a Rand policy researcher, said in a statement. “The fact that we could not reach anyone at one in five facilities suggests that many people may have trouble reaching a clinic to inquire about mental health care.”

Of the facilities they could reach, 87% were accepting new patients, and 80% of those providers said they offered telehealth services. 

Nearly 97% of current telehealth providers reported offering counseling services, while nearly 77% provided medication management and almost 69% offered diagnostic services. 

But virtual care availability and the type of care offered varied based on facility type and location. Private facilities were nearly twice as likely to offer telehealth compared with public providers, which may reflect the different patient populations served by these facilities, according to Cantor.

Wait times also varied across states. The median number of days until a first appointment was 14, but callers in some locations would have to wait much longer before they received care. In Maine, the median wait time for a telehealth appointment was 75 days, compared with just four days in North Carolina. 

The researchers found some “encouraging” signs about telehealth access. Available services didn’t vary significantly based on the patient’s perceived race and ethnicity, their clinical condition or county-level sociodemographic details.

But the results suggest some patients could still struggle to find the services they need.

“[…] The patient must successfully contact the facility, confirm that the facility is accepting new patients and that it accepts the patient’s insurance, and must identify a facility that offers the specific telehealth services for their mental health needs,” the study’s authors wrote.