Telehealth Mental Health Counseling: What It Is and Why It Matters

January 16, 2024

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A counselor meets with a patient via video call. In 2019, before the COVID-19 pandemic, nearly 20% of adults in the U.S. experienced a mental illness, yet over half of them didn’t get treatment, according to Mental Health America. Similarly, 15% of youth suffered major depression, yet more than 60% of those young people didn’t receive treatment.

These figures have only increased during the pandemic; for example, the Kaiser Family Foundation (KFF) reports that more than 31% of U.S. adults reported experiencing symptoms of anxiety and/or depressive disorder as recently as March 2022. However, barriers to treatment, such as lack of access to mental health providers, remain a challenge for many populations.

One way to remove those barriers to treatment is through telehealth.

Telehealth, also called telemedicine, is medical care delivered via teleconference, phone calls, or secure messaging apps such as email or text. Data shows that telehealth mental health counseling can be effective at bridging the treatment gap. Professional counselors who embrace telehealth can increase its acceptance and help treat patients who otherwise would not have access to services. Online master’s degree programs in mental health counseling provide a framework for understanding the role that telehealth can play in treatment.

Telehealth in Mental Health Counseling

Therapists provide telehealth counseling services over the internet via laptops, phones, or tablets. They may meet with patients in private sessions or conduct group therapy, depending on the mode of treatment. Even before the pandemic, telehealth was growing as an element of mental health care. Studies dating back to 2012 and earlier show that telehealth can be effective in treating many disorders.

Data from KFF paints a picture of telehealth in 2021:

Depression. Around 35% of outpatient visits for those with depression were telehealth visits.
Anxiety. Approximately 38% of anxiety patients were treated via telehealth.
Substance abuse. Substance abuse disorder patients used telehealth to treat issues with alcohol (29%), opioids (29%), and stimulants (16%).
Psychotherapy. Patients treated via telehealth included those with bipolar disorder (31%), neuro-developmental issues (34%), and schizophrenia (33%).

Many factors can impact the effectiveness of telehealth mental health counseling.

Technology

Slow or dropped connections can interfere with telehealth consultations. Patients may be distracted by texts or emails. Videoconferencing can make it difficult to read body language — although that may benefit patients with anxiety or autism spectrum disorder. Additionally, therapists have noted that some patients who might have been overwhelmed in a counselor’s office found it easier to discuss their symptoms via phone or video.

HIPAA

Patient privacy is a top priority of Health Insurance Portability and Accountability Act (HIPAA) regulations, and telehealth apps must meet these standards. Some providers set up private networks that meet HIPAA standards or use industry-standard apps, such as Teladoc. However, during the pandemic, the federal government relaxed these standards to allow telehealth to be conducted over commercial networks.

Access and Cost of Care

Many Americans lack health insurance or have plans that don’t cover mental health services. They may lack reliable internet connections, devices such as tablets or smartphones to connect with, or even the privacy for a therapy session. Medicare reimburses telehealth services at a lower rate than in-person care, which may deter providers from offering telehealth mental health counseling.

The Importance of Utilizing Telehealth

The use of telehealth for mental health counseling has proven to be highly effective for several years. According to a 2021 report by the Substance Abuse and Mental Health Services Administration, the breadth of research since 2010 shows strong evidence for telehealth having a positive impact that is equal to or better than in-person treatment for patients with a serious mental illness or substance use disorder. These results underscore the need to continue providing telehealth as the country moves into a post-pandemic health care environment. Counselors who incorporate telehealth into their treatment options can help meet the rising demand for services.

Telehealth and the Pandemic

Mental health issues skyrocketed during the pandemic. Three in 10 adults have reported depression and anxiety symptoms since April 2020, according to KFF. Telehealth rose to the challenge. Prior to the pandemic, less than 1% of mental health visits were telehealth; during the pandemic, that figure grew to 40%, KFF reports. The federal government relaxed HIPAA regulations and also permitted health care providers to practice medicine across state lines.

Telehealth and the Post-Pandemic Era

As the nation eased out of lockdown, the percentage of overall telehealth visits dropped to 5%, KFF reports. Mental health telehealth usage has remained high, however; 36% of all telehealth visits are for mental health treatment. These figures may stabilize or continue to grow. Some private insurers have increased their mental health coverage, according to KFF, which may lead to more utilization.

Reducing the Treatment Gap

Access to treatment is one of the biggest issues that patients with mental health disorders face. They may lack transportation, especially if they’re low-income. They may live in a health professional shortage area, which describes many rural regions in the U.S. They may be part of a specific population that lacks equal access to care. Telehealth can circumvent some of these challenges, although connectivity and technology issues remain.

Blended Care

Providers have found that telehealth mental health counseling that incorporates blended care is highly effective. Blended care combines real-time telehealth services with other digital technologies that allow patients to complete tasks on their own, such as questionnaires, learning modules, and intake forms. Blended care, or asynchronous care, can let therapists and patients cover more ground in sessions by taking some of the homework out of it.

The Benefits of Telehealth

Telehealth provides advantages to providers and patients alike, in addition to its effectiveness in treating mental health disorders. Some of these benefits include:

Fewer visit cancellations. The convenience of telehealth means that patients are less likely to cancel visits. This can provide a more consistent therapy experience.
Billing and reimbursement. Both private insurers and Medicare reimburse for telehealth visits, although reimbursement rates may be lower than in-person visits.
Maintaining relationships. It used to be that if a patient moved, the relationship between counselor and patient was inevitably severed. Now, counselors can continue to treat patients who move or who otherwise can’t manage in-person visits.
Patient reluctance. Many people perceive mental health needs as a sign of weakness. Telehealth can help patients maintain their privacy and make it easier for them to overcome this stigma.

Make a Direct Impact in People’s Lives

As a mental health professional, you can have a direct impact on people’s lives. Telehealth mental health counseling will become an increasingly important part of your tool kit in meeting patients where they are and helping them in the most effective way possible. Explore Bradley University’s online Master of Arts in Counseling program and learn how its clinical mental health counseling track can help you pursue your mental health practitioner goals.

Recommended Readings

How to Become a Mental Health Counselor

What Are the Clinical Mental Health Specialty Courses?

Managing Traumatic Grief and Coping After National Crises

Sources:

American Psychological Association, “Online Therapy Is Here to Stay”

Centers for Disease Control and Prevention, Youth Risk Behavior Survey

Health Resources & Services Administration, Telehealth Licensing Requirements and Interstate Compacts

Health Resources & Services Administration, “What Is Shortage Designation?”

HIPAA Journal, HIPAA Guidelines on Telemedicine

Kaiser Family Foundation, Adults Reporting Symptoms of Anxiety or Depressive Disorder During COVID-19 Pandemic

Kaiser Family Foundation, “Telehealth Has Played an Outsized Role Meeting Mental Health Needs During the COVID-19 Pandemic”