Rise in Telehealth Compensated for Pandemic Disruption of In-Person Mental Health Care

Utilization rates of in-person mental health services in the United States dropped 50% during the first year of the COVID-19 pandemic—a decrease that was completely offset by a rapid rise in telehealth services, according to study results published online in JAMA Health Forum.

“For 3 categories of conditions (anxiety disorders, major depressive disorder, and adjustment disorders), we also found evidence that service utilization rates increased throughout the pandemic compared with before the pandemic’s onset,” wrote corresponding author Christopher M. Whaley, PhD, of RAND Corporation in Santa Monica, California, and coauthors.

The cohort study included 5.1 million adults from a national US database of commercial medical claims from January 5, 2020, to December 21, 2020. Researchers investigated changes in service utilization rates following the national public health emergency declaration on March 13, 2020.

Per 10,000 enrollees, in-person care for major depressive disorder decreased by 6.44 weekly beneficiaries from a baseline mean of 11.66, according to the study. For anxiety disorders, in-person care decreased by 5.28 weekly beneficiaries per 10,000 from a baseline mean of 12.24; for bipolar disorder, in-person care decreased by 1.81 weekly beneficiaries from a baseline mean of 3.32; for adjustment disorders, in-person care decreased by 6.78 weekly beneficiaries from a baseline mean of 12.14; and for post-traumatic stress disorder, in-person care decreased by 2.00 weekly beneficiaries from a baseline mean of 4.93.

Meanwhile, telehealth service utilization rose 16- to 20-fold over the same period, the study found. The increase was highest for anxiety disorders, which grew by 9.12 weekly beneficiaries per 10,000 enrollees from a baseline mean of 0.20. For major depressive disorder, telehealth care increased by 5.97 weekly beneficiaries per 10,000 enrollees from a baseline 0.10, and for adjustment disorders, by 5.95 weekly beneficiaries from a baseline 0.13.

“It will be important to observe whether and to what extent these trends continue to shift,” researchers wrote, “particularly if and when impermanent legislation to support telemental health services expires or is withdrawn.”

Reference:
McBain RK, Cantor J, Pera MF, Breslau J, Bravata DM, Whaley CM. Mental health service utilization rates among commercially insured adults in the US during the first year of the COVID-19 pandemic. JAMA Health Forum. Published online January 6, 2023. doi:10.1001/jamahealthforum.2022.4936