Telehealth for mental health care increased more during pandemic than in-person care dropped
Telehealth services for common mental health problems surged 16 to 20 fold during the first year of the COVID-19 pandemic, more than making up for a drop in in-person care that occurred during the period for a number of conditions, according to a new RAND Corporation study.
Examining the experiences of more than 5 million adults withprivate health insurance, researchers found that in-person services for depression disorders, anxiety disorders, bipolar disorder, adjustment disorders andposttraumatic stress disorderdropped by more than 50% after thepublic health emergencywas declared in 2020.
While use of in-personmental health caredropped sharply, telehealth services grew steadily during the first year of the pandemic. By December of 2020, treatment of mental health services for some of the disorders was 10% to 20% higher than in January 2020. The study is published inJAMA Health Forum.
"Our findings highlight a remarkable transition in the U.S. mental health system from in-person to virtual care," said Christopher M. Whaley, senior author of the study and an economist at RAND, a nonprofit research organization.
While the increased use of telehealth mental health services during the pandemic has been well known, the 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.
Many prior studies have documented an elevated level of psychological distress and mental health disorders such as anxiety and depression over the course of the COVID19 pandemic.
Meanwhile, concerns about the spread of the coronavirus have led manymental health providersto 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 mental health services after the start of the pandemic, researchers examined claims from commercially insured adults from January to December 2020. The claims information was from 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 forbipolar disorderand 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 ofmental health servicesforanxiety disordersduring the pandemic was higher for women than for men.
Among the group studied, people inrural areaswere less likely to use telehealth services. In addition, people over the age of 46 had lower rates of services than younger adults.
“虽然这可能是部分原因是prevalenc较低e 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.
