Study Shows Impact of Telehealth on Rural Mental Health Services

Before the COVID-19 pandemic, telemedicine acceptance and implementation was already on a fast growth track. Lockdowns and forced isolation plus the fear of COVID infection boosted telehealth adoption even faster and further into new areas of healthcare. Telemedicine’s primary benefits are increased access to care, savings in time and money compared to in-person clinical visits, and improved health outcomes. Researchers from Harvard Medical School’s Department of Health Care Policy and Stanford University recently published the results of an original investigation into the use of specialty mental health care and medication adherence with telemedicine in nonmetropolitan areas prior to the COVID lockdown.

The challenge of delivering healthcare services to people with severe mental health issues is often exacerbated by the diseases. Patient adherence to medication regimens is also particularly challenged by serious mental illness. The Harvard and Stanford researchers explored whether telemedicine’s increasing availability is associated with both aspects of healthcare for patients with severe mental health issues. The study analyzed data from nearly 120,000 patients with schizophrenia, other psychotic disorders, or bipolar I disorder (aka “manic depression). The patients in the study were Medicare beneficiaries from 2,916 nonmetropolitan counties who received services from the 2010 through 2018. Medicare did not reimburse telemedicine services for metropolitan beneficiaries during the years covered by the study.

The researchers tracked the number of patients who had two or more specialty health service visits, medication adherence, hospitalization rate, and outpatient follow-up visits in a year following a mental health hospitalization. The study authors reported that increases in telemental health visits were associated with modest increases in outpatient contact with mental health professionals, increased hospitalizations, and follow-up after discharge. The study found no significant change in medication adherence.

This study suggests that the availability of telemedicine may lead to increased use of professional mental health services by people with severe mental illness, but it’s also important to note that the study timeline bridged the introduction of telemental health in most of the U.S. The Harvard and Stanford investigation results are interesting but warrant further tracking with more recent data before making final conclusions.