Understanding the Availability of Mental Telehealth Services

Between December 2022 and March 2023, researchers contacted more than 1,900 outpatient mental health care facilities to ask about telehealth services. The underlying sample came from outpatient mental health treatment centers, not individual professionals.

The researchers used a secret shopper approach, using a script that reflected the information a potential 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 through 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 acted 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, the researchers received a response from 1,404. Of them, 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 centers 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 centers that responded, most 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 in the United States.

The researchers note that telehealth services and availability may differ in 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