Telehealth and In-Person Behavioral Health Services in Rural Communities Before and During the COVID-19 Pandemic:...

Area of Science:

• Health Services Research
• Telehealth
• Behavioral Health

Background:

• The COVID-19 pandemic necessitated rapid adjustments in US healthcare delivery.
• Telehealth adoption surged for mental health services, addressing pre-existing access gaps and acute needs.
• Changes in behavioral telehealth services, especially in rural areas, remain under-documented.

Purpose of the Study:

• To investigate shifts in patient and treatment characteristics for behavioral health services.
• To compare changes between telehealth and in-person services before and during the COVID-19 PHE.
• To analyze data from 95 rural US communities.

Main Methods:

• A nonrandomized, prospective, multisite research design with two cohorts: telehealth and in-person.
• Data collected for 3 months post-treatment initiation for each patient.
• Chi-square tests compared pre-PHE and PHE periods for patient diagnosis, clinician type, and service type.

Main Results:

• Telehealth saw increased encounters for anxiety, dissociative, and stress-related disorders (30% to 35%).
• In-person services experienced increased encounters for substance use disorders (11% to 18%).
• Telehealth and in-person services both saw increases in alcohol/drug/medication-assisted therapy, while in-person group therapy decreased.

Conclusions:

• Health service providers adapted both telehealth and in-person behavioral therapy delivery during the pandemic.
• Further research is needed to understand the interplay of patient, provider, setting, and intervention factors influencing observed patterns.