Mental Health Telemedicine Barriers Spur Call for Reform

During the COVID-19 pandemic, telemedicine was an essential part of the continuity of care for mental health. Patients using audio-only telehealth services were found to have a lower socioeconomic status and reported more depression, anxiety, and neglect than patients using video telehealth, according to another abstract presented at APHA.¹ This may be because individuals utilizing audio-only telehealth may not have access to resources needed for video telehealth.

Utilizing patients enrolled in the MOBILITY clinical trial (NCT02515773), researchers developed the MOBILITY-TEACH research study. The goal was to evaluate the impact of the dramatic shift in health care delivery during the pandemic on patients with bipolar spectrum disorders. Specifically, investigators sought to evaluate whether audio-only or audio-plus-video mental health care delivery was associated with higher rates of patient-reported depression, anxiety, and neglect.

Families enrolled in MOBILITY were asked to complete an online survey and telephone interview from December 2020 to October 2021. The survey concerned the impact of and barriers to mental healthcare delivery during the pandemic. Patients were aged 8 to 23 years.

A total of 262 patients and 281 caregivers completed the survey and interview. Patients who used audio-only telehealth (9%) saw significantly higher levels of depression and anxiety and had a lower socioeconomic status based on household income than those using video telehealth (47%).

Patients who used audio-only telehealth reported more neglect (14% vs 1%). Most patients and caregivers also reported at least 1 barrier to receiving mental healthcare through telemedicine, the most common being technical difficulties.

“This disparity may reflect less available resources, greater ease to report negative states via audio, or other factors, but indicates a need for policymakers to continue telehealth services, reimbursement for audio-only visits, and provide disadvantaged populations with technology to access video mental healthcare services,” the researchers concluded.

Reference

1. Simon M, Klein C, Crystal S, et al. Utilizing telemedicine for mental healthcare during COVID-19: implications for post-pandemic policymaking.Presented at: 2022 American Public Health Association Annual Meeting and Expo; November 6-9, 2022; Boston, MA.