The COVID-related pivot to telehealth has highlighted its capacity to maintain and improve mental health services’ continuity. Brian K. Ahmedan and research team members published a large-scale retrospective study in Psychiatric Services on October 11, 2023. This foundational study offers the most extensive examination of psychotherapy treatment disruptions in the United States. It compares the nine months preceding and following the onset of COVID-19 and identifies some of the most influential benefits of telehealth.
Rapid Transition & Its Impact
As part of a broader examination, this study has documented a remarkable shift in the landscape of psychotherapy, corroborating the experiences of major US health systems. Key findings revealed that post-COVID-19, telehealth clients and patients were more likely to maintain regular psychotherapy appointments with significantly reduced intervals between sessions. Not only did this indicate better adherence to mental health care regimens with telehealth, but it also highlighted the role of virtual care in addressing the heightened demand for mental health services during such challenging times.
This study retrospectively analyzed health records and insurance claims from three US health systems to evaluate the impact of the COVID-19 pandemic on the continuity of psychotherapy care. It involved a cohort of 110,089 patients with mental health conditions who were enrolled in the health systems’ health plans. The patients had participated in at least two psychotherapy sessions during the period spanning from June 14, 2019, to December 15, 2020.
Researchers divided the data into two segments, comparing two nine-month periods before and after the onset of COVID-19 (defined as March 14, 2020). Psychotherapy sessions were tracked and categorized as either in-person or virtual. The study described a disruption in psychotherapy care as a gap exceeding 45 days between appointments.
Demographics & Disparities
A salient aspect of this research contradicts prevailing beliefs about disparities in virtual mental health care. Previous studies suggested that older populations and those in rural areas faced more significant disruptions in care, while minoritized racial-ethnic groups experienced disparities in adherence. Interestingly, the current study observed reduced inequities after the widespread implementation of virtual care. The authors argue that their findings indicate that telehealth may be a great equalizer in psychotherapy, capable of transcending geographical and sociodemographic barriers.
While this may be true to some extent, other research suggests that studies explicitly designed to detect disparities show alarming results that more clearly reflect disparities when they exist.
The Specific Benefits of Telehealth in Psychotherapy
The benefits of telehealth extend beyond accessibility, offering advantages compared to in-person visits. Virtual care has shown to be particularly beneficial in psychotherapy due to the flexibilities surrounding the following:
- Reduced need for transportation
- Decreased work absenteeism
- Potential to lessen the stigma associated with mental health care
- Continued access to virtual mental health services for geographically disparate groups, such as people living in rural areas.
Technological & Privacy Considerations
Despite its advantages, successful virtual psychotherapy hinges on the availability of reliable Internet service and up-to-date computer technology. Privacy remains a significant concern, requiring further research into the nuances of therapist-patient interactions and the evaluation of nonverbal cues within virtual sessions. Patient preferences also play a crucial role in deciding the appropriateness of virtual versus in-person therapy.
Study Limitations & Avenues for Future Research into the Benefits of Telehealth
It is crucial to consider the limitations of the study. The analysis did not include first-time psychotherapy visits, and reasons for disengagement were not explored. The study focused on three large health systems with pre-existing virtual care infrastructures, which may not represent all settings. Notably, the study did not evaluate the effectiveness or benefits of psychotherapy in terms of health outcomes. Future research should delve into these areas to ensure a comprehensive understanding of virtual care’s impact.
Concluding Thoughts on the Benefits of Telehealth Continuance
The study’s findings, involving a review of records for over 110,000 individuals with mental health conditions, support the assertion that virtual psychotherapy can significantly reduce treatment disruptions. The compelling evidence favoring virtual care’s ability to ensure consistent psychotherapy underscores its importance as a viable care option, provided the necessary infrastructure and policies are in place to support access and coverage. Thus, as the healthcare landscape continues to evolve, the many benefits of telehealth for psychotherapy stand as a testament to the resilience and adaptability of mental health services in the face of global challenges.
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