For years, the United States has been experiencing an acute shortage of mental health professionals. Despite this shortage, the need for more accessible and effective mental health care continues to increase especially with the rise of opioid addiction epidemic particularly in the rural areas. Throughout the country, many of those who need mental health care have difficulties accessing it or choose not to seek help for fear of social stigma associated with mental illness. But according to a new report on telemental health, things are changing; there has been a significant growth in the use of telemedicine particularly among the Medicaid beneficiaries in the rural areas.
The report, however, indicates that this growth has been rather uneven across the population. The authors of the report led by Ateev Mehrotra, a professor of health policy at Harvard, noted that although there was rapid nationwide growth in mental health use among rural Medicaid beneficiaries, the use was not even in the population. For instance, between 2004 and 2014, the growth among beneficiaries with any mental health problem averaged at 45.1 per year while growth among beneficiaries with serious mental health conditions averaged at 49.3% per year.
The report also pointed to a signification variation from state to state. There were at least 25 visits per 100 beneficiaries in 9 states. The DC and four other states had no visits in the entire sample. The report did not cite the cause of the variation between states, but it did note that states with A-rating from the American Telemedicine Association with regards to the regulatory environment and those with telemedicine parity laws had higher rates of use.
The report also noted that there was significant variation in terms of the health professionals the mental health patients are visiting. 65.3% visited psychiatrists, 99.9% visited nurse practitioners, while 8.8 consulted clinical psychiatrists.
What is more interesting about the report is that it indicates that 87.3 of those who use telemental health also make in-person visits. This is worrying to those who have been arguing that telemedicine avails mental health service to those living in communities without such care. Indeed, only 12.7 use telemental healthcare exclusively. To this end, it is apparent that telemental health is complementing the in-person visit care.
In conclusion, the report recommends that any future payment policy for emerging health technology must insist on encouraging high-value care because in telemedicine, for instance, low-value care could be overshadowed by convenience.