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Tele-mental Health Use Surged in Year 1 of Pandemic

In contrast, in-person services for common mental health disorders dropped by more than half after the PHE was declared in 2020.

Telehealth for common mental health issues grew up to 20 fold in the first year of the COVID-19 Pandemic, more than compensating for a concurrent drop in in-person care for a number of conditions, a RAND Corporation study shows.

The RAND study is the first to show that the magnitude of the increased use of telehealth more than made up for the decline in in-person treatment.

An examination of more than 5 million privately insured adults, the researchers found that in-person services for depression, anxiety, bipolar, adjustment, and posttraumatic stress disorders dropped by more than half after the public health emergency was declared in 2020.

In sharp contrast, telehealth use grew steadily during the first year of the pandemic. By December of 2020, tele-mental health treatments for some disorders was 10% to 20% higher than in January 2020, according to the study, which was published in JAMA Health Forum.

“Our findings highlight a remarkable transition in the U.S. mental health system from in-person to virtual care,” says RAND economist Christopher M. Whaley, senior author of the study.

Other studies have documented an elevated level of psychological distress and mental health disorders such as anxiety and depression over the course of the COVID-19 pandemic.

Meanwhile, concerns about the spread of the coronavirus have led many mental health providers to eliminate or reduce in-person services.

In response, many providers switched to providing telehealth mental health services, and both public and private insurance providers expanded coverage for telehealth services.

To examine trends in tele-mental health, researchers looked at claims from commercially insured adults from January to December 2020, as provided by Castlight Health, a health benefit manager for employer-sponsored health insurance plans for about 200 employers in all 50 states.

The study found that the increased use of telehealth was lowest for bipolar disorder and highest for anxiety disorders.

When combining in-person and telehealth service treatment rates, there was an overall increase in care for major depressive disorders, anxiety disorders, and adjustment disorders. The increase in use of mental health services for anxiety disorders during the pandemic was higher for women than for men.

People in rural areas were less likely to use telehealth services, and people over age 46 also had lower rates of services than younger adults.

“While this may be partly due to a lower prevalence of certain conditions among older Americans, the consistency of this trend across different diagnosis categories suggests that factors such as lower digital literacy and less comfort with using telehealth also may play a role,” said Ryan K. McBain, lead author of the study and a policy researcher at RAND.

Support for the study was provided by the National Institutes on Aging and the Robert Wood Johnson Foundation.  

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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