A new study of virtual mental health access adds detail to the US telehealth portrait
RAND Corp study reveals significant regional variation in access to specific features of virtual mental health services. However, the study found no evidence that telehealth exacerbated access issues, particularly for vulnerable populations.
“The findings of this anonymous shopper survey are encouraging in that we did not observe a systematic bias in which available services differed based on the client’s race and ethnicity, the client’s stated clinical condition, or sociodemographic characteristics at the level of district,” the study states.
The study found that patients continued to face phantom network problems. About 21% of the 1,938 nationally representative outpatient mental health treatment facilities contacted by the researchers could not be reached.
“The fact that we can’t reach anyone at one in five facilities suggests that many people may have difficulty reaching a clinic to ask about mental health care,” Jonathan Cantor, the study’s lead author and research fellow, said in a news release. RAND Corp. policies. release
Across all facility types, 87% said they were accepting new patients and 80% said they offered telehealth services.
Virtual mental health is exceptional in the wider context of telehealth. It is the only healthcare sector that maintains high utilization rates after the acute phase of the coronavirus pandemic. Separate research shows that mental health-related diagnoses were behind 66.4% of all telehealth insurance claims in November 2023, according to FAIR Health.
However, the exact picture of virtual mental health as a whole is not fully known, the study said, noting further that little “is known about the availability and composition of mental health telehealth services.”
Regionality has a significant impact on what services are likely to be available. Facilities in metropolitan areas are more likely to offer medication management but significantly less likely to offer diagnosis. In total, about 1 in 4 clinics did not offer virtual medication management, while about one in three did not offer virtual diagnostic services.
The regional picture also varies when it comes to wait times for a first appointment. Across all states, the median wait time was 14 days, with a range of 4 days (North Carolina) to 75 days (Maine).
The ownership status of the facility had some impact on service availability. Privately owned facilities that offered only outpatient mental health were more likely to offer telehealth services, twice the rate of public facilities, which were less likely. Private for-profit facilities were also less likely to offer medication management but more likely to offer diagnostic services.
“No differences were found to be associated with the race, ethnicity, sex, or perceived mental health status of the client-caller,” the report states.
Payer source also appears to have influenced the availability of virtual mental health services. Facilities that reported Medicaid as an acceptable form of payment were significantly more likely to offer counseling services via telehealth compared to facilities that did not accept Medicaid, the report said.
Here is an overview of the virtual mental health modalities offered by the facilities:
— 47%, only via video call
— 47%, both by video and by phone
— 5%, by phone only
– 1%, did not know
Here is a summary of the services offered:
— 97%, consulting services
— 77% medication management
— 69% diagnostic services
Telehealth continues to be a hot topic at the top of the US regulatory apparatus. Last month, federal lawmakers proposed a bill that would eliminate the in-person exam for virtual mental health services for those on Medicare. Medicare is seen as a vanguard for the rest of the payer market. It also continues to be a convenient tool for Congress to reach people in rural communities who need mental health services. Another bill proposed in December calls for some reforms for that population.
One of the most pressing regulatory issues remaining from 2023 involves the federal government’s regulation of the prescribing of controlled substances via telehealth. During the pandemic, the Trump administration established several flexibilities, some of which were exceptions to these laws. Now, it’s a question of whether or not they will become permanent under the Biden administration.