From the Guidelines
Telehealth for mental health services is at least similarly effective as non-telemental healthcare, particularly when the comparison arms are otherwise equivalent treatment. The benefits of telehealth include improved accessibility, convenience, and potentially lower costs, which can lead to better appointment adherence and reduced no-show rates 1. Many patients feel more comfortable discussing sensitive issues from their own environment, which can accelerate therapeutic progress. However, there are some notable limitations to consider, such as technology barriers, potential difficulties in establishing a therapeutic connection, and the possibility of missing important non-verbal cues or physical symptoms.
Key Considerations
- Patient characteristics, such as diagnosis, age, and clinical or demographic factors, may influence the effectiveness of telemental health compared to in-person care 1.
- The type of telemental health, such as phone versus video conferencing, may also impact treatment outcomes, with phone visits potentially lacking visual non-verbal cues and being more prone to distractions 1.
- Certain clinical populations, such as children and adolescents, or treatment modalities, like group psychotherapy, are under-represented in the current literature, highlighting the need for further research 1.
Clinical Implications
- The decision to use telehealth or in-person services should be based on individual patient needs, technological capabilities, and the specific mental health condition being treated.
- Clinicians should be aware of the potential limitations of telehealth and take steps to mitigate them, such as using video conferencing instead of phone visits when possible, and being mindful of non-verbal cues and physical symptoms.
- Further research is needed to fully understand the effectiveness of telemental health and to address the current limitations in the literature, particularly with regards to under-represented populations and treatment modalities 1.
From the Research
Pros of Telehealth for Mental Health Services
- Increased accessibility: Telehealth can provide effective and adaptable solutions to the care of mental illnesses universally, especially in isolated communities 2.
- Cost-effective: Telehealth is particularly advantageous and inexpensive through the use of current technologies and adaptable designs 2.
- Improved attendance: Attendance significantly improved after the transition to telehealth, as indicated by fewer cancellations and more appointments attended 3.
- Increased access to care: Telehealth can increase access to mental health services, particularly in rural locations where there is a lack of psychiatric providers 4.
- Patient satisfaction: Patients have shown comfort with telehealth and a willingness to continue to see mental health professionals in this venue 4.
Cons of Telehealth for Mental Health Services
- Limited availability: Telehealth availability may vary across facilities, geographic areas, and by patients' demographic characteristics and mental health conditions 5.
- Disparities in access: Differences were found in the availability of telehealth services at the facility-, county-, and state-level, suggesting widespread disparities in who has access to which telehealth services throughout the US 5.
- Technical issues: While not explicitly stated in the studies, technical issues such as poor internet connectivity or equipment malfunctions can be a potential con of telehealth.
- Limited non-verbal cues: Telehealth may limit non-verbal cues, such as body language and facial expressions, which can be important in mental health assessments and therapy.
Effectiveness of Telehealth for Mental Health Services
- Comparable to in-person services: Telehealth has been shown to be comparable to in-person services in terms of effectiveness, with patients showing significant improvement and decreases in symptoms 3.
- Effective interventions: Telehealth can provide effective interventions to patients with various mental illnesses, including depression, anxiety, and schizophrenia 2, 4.
- Medication adherence: Telehealth has been shown to improve medication adherence, with one study finding that medication adherence was 82% at 30 days and 77.5% at 60 days 4.