• Research Highlights
During the coronavirus pandemic, public health measures and restrictions impacted in-person healthcare visits, leading to a surge in telehealth services as a way to access assessment and treatment. In particular, in the mental health arena, telehealth saw a significant increase and its use remains high even after the pandemic. However, despite the increase in utilization of telehealth services, there is limited understanding of the availability and structure of these services.
What did the researchers do?
In a NIMH-funded study, researchers led by Dr. Jonathan Cantor RAND Corporation investigated the availability of different types of telehealth services and the time it took for patients to access telehealth care.
Between December 2022 and March 2023, researchers contacted more than 1,900 mental health outpatient treatment centers to ask about telehealth services. The underlying sample came from mental health outpatient treatment centers, not individual practitioners.
The researchers used a secret shopper approach, using a script that reflected information a prospective patient might ask when requesting telehealth services. Secret shoppers asked about the availability of telehealth services to treat major depressive disorder, generalized anxiety disorder, or schizophrenia. They also asked about specific services offered via telehealth (behavioral therapy, medication management, diagnostic services) and the number of days they would have to wait before having their first telehealth appointment. Both men and women served as secret shoppers, and the names used by the shoppers were chosen to reflect a variety of racial and ethnic backgrounds.
What did the researchers find?
Of the more than 1,900 centers contacted, researchers received responses from 1,404. Of those, 1,221 were accepting new patients. Of those 1,221 centers, 80% (980) offered telehealth services. Of the 980 treatment centers that offered telehealth services:
- 97% provided advisory services.
- 77% provided medication management.
- 96% provided diagnostic services.
Among facilities that responded to the telehealth question, researchers found:
- Private for-profit and nonprofit treatment centers were more likely to offer telehealth services than public treatment centers.
- Treatment centers in metropolitan areas were more likely than nonurban areas to offer medication management, but less likely to offer diagnostic services.
- The average wait time for a telehealth appointment was 14 days (range 4-75 days, depending on the facility contacted).
What do the findings mean?
Researchers found that some of the facilities they initially contacted for information did not respond, suggesting that people seeking any type of mental health care may encounter barriers to accessing it.
Of the responding facilities, the majority were accepting new patients and providing telehealth services; however, the availability of those services and the type of care offered varied by location and state. This suggests that there may be disparities in access to telehealth services across the United States.
The researchers note that telehealth services and their availability may differ at health centers not included in this study and that the availability of technology that makes telehealth possible (such as broadband services) was not examined in this analysis.
Reference
Cantor, J., Schuler, M.S., Matthews, S., Kofner, A., Breslau, J., & McBain, R.K. (2024). Availability of telemental health services in the U.S. JAMA Health Forum, 5(2), Article e235142. https://doi.org/10.1001/jamahealthforum.2023.5142
