A recent study reveals that nearly one-third of behavioral healthcare patients in the United States struggle to access their preferred treatment mode, either telehealth or in-person visits. The study, conducted by RAND Corporation and Harvard University, underscores the importance of accommodating patient preferences in clinical and policy decisions. While telehealth offers convenience, the absence of in-person options leaves patients feeling disconnected. Another study demonstrates higher no-show rates for telehealth in rural areas, suggesting the need for a balanced approach to behavioral healthcare delivery.
A recent study highlights the surging demand for behavioral healthcare services, with an alarming finding that almost one-third of behavioral healthcare patients are unable to access their preferred mode of treatment, be it telehealth or in-person visits.
This study, featured in Health Affairs, was conducted by researchers hailing from the RAND Corporation, a nonprofit research organization, and Harvard University, and was financially supported by the National Institute for Mental Health.
To arrive at their conclusions, the researchers conducted a nationally representative survey involving 2,071 adults in the United States during February and March. Within this cohort, 571 individuals had utilized behavioral health services in the preceding year. Additionally, 26 individuals dealing with bipolar disorder or depression were interviewed as part of the study. Both the survey and interviews delved into patients’ experiences in choosing between telehealth and in-person care for their behavioral health needs and their overall satisfaction with this decision.
The study reveals some striking disparities in the utilization of these two treatment modalities. For those who received individual therapy (423 respondents), a substantial 80.1 percent opted for telehealth visits in the previous year, while only 41.6 percent chose in-person visits.
In contrast, among the 373 individuals seeking medication-related visits, 54.4 percent engaged in telehealth, and 57.9 percent opted for in-person visits.
Additionally, the researchers discovered that a concerning 30.6 percent of respondents receiving therapy reported that their clinician exclusively offered a visit modality. Of these, 21.6 percent were limited to telehealth, and 9 percent to in-person care.
Regarding medication visits, 33.2 percent of respondents indicated that their clinician provided only one visit modality, with 20.3 percent offering in-person visits and 12.9 percent offering telehealth visits.
Furthermore, about 24.2 percent of individuals receiving therapy and 34.9 percent receiving medication reported that their provider unilaterally determined the visit modality. While most respondents acknowledged that their clinician took their preferences into account when deciding on the mode of treatment, there remained a significant minority who disagreed. Approximately 32 percent of patients reported not receiving their preferred type of visit most of the time, and 45 percent believed their clinician did not consider their preference when determining the visit type.
Jessica Sousa, the lead author of the study and a senior policy analyst at RAND, emphasized the need for greater consideration of patients’ modality preferences in both clinical discussions and policy decisions. She stressed that while many patients appreciate the convenience of telehealth, others find in-person care more conducive to building rapport with clinicians and fostering a focused environment during visits.
Moreover, the absence of choice in treatment modalities has left patients feeling disconnected and less engaged with their clinicians, especially those who prefer in-person care.
Sousa pointed out that while expanding telehealth has improved access to care, it may not be sufficient on its own. Ideally, patients should have access to both telehealth and in-person care options, given that many individuals prefer or may require the latter.
As telehealth continues to play a prominent role in the delivery of behavioral healthcare, studies have also shed light on some of its drawbacks. Another study, published in July, highlighted the challenges faced by behavioral health patients when using telehealth technology, resulting in higher no-show rates. The study compared no-show rates between telehealth visits and in-person care using electronic health record (EHR) data from outpatient clinics in rural Louisiana between May 1, 2022, and January 31, 2023. The findings indicated a 17 percent no-show rate for telehealth appointments, in contrast to a 13 percent rate for in-person care.
