Understanding the Optimal Balance of Using Telehealth and In-Person Services to Support Adults with Serious Mental Illness and Children with Serious Emotional Disturbance
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Associated Project
Policy and Data Analysis to Support the Office of Behavioral Health, Disability, and Aging Policy
Prepared for:
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation
Key Findings
- Providers, clients, and caregivers believe telehealth can support mental health care for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED) when balanced appropriately with in-person services.
- Both providers and clients value the flexibility to make choices about the appropriateness of telehealth and believe telehealth helped expand access to mental health care for underserved groups. Decisions about when and how to use telehealth should consider treatment goals and clients’ symptom severity, safety, preferences, and comfort with technology.
- In some cases, people receiving services were unable to choose between telehealth and in-person care due to the lack of local mental health providers within their insurance networks and providers reported confusion about their ability to deliver telehealth services across state lines because of state-specific license and insurance-related restrictions.
- Behavioral health systems and policymakers can provide practical guidance on how to choose between these modalities of care, incentivize provider participation in insurance networks and ensure adequate network adequacy standards for behavioral health, and monitor the quality and outcomes of care to safeguard against potentially inappropriate substitution of telehealth for in-person services.
This brief summarizes findings from a research project that examined access to and use of tele-mental health services among individuals with serious mental illness (SMI) and children with serious emotional disturbance (SED) and behavioral health consumer and provider perceptions of the optimal balance of telehealth and in-person services for people with SMI and SED. The brief reflects feedback from focus groups providers, caregivers and patients from across the country on factors considered when deciding between use of in-person care or telehealth, and how they balance the use of each modality while considering patient safety, access to care, and the structural influences of the mental health system. Behavioral health systems and policymakers can provide practical guidance to providers on how to choose between these modalities of care, can incentivize provider participation in insurance networks, can ensure adequate network adequacy standards for behavioral health and can monitor the quality and outcomes of care to safeguard against potentially inappropriate substitution of telehealth for in-person services.
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