What Is Telemental Health: Benefits, Privacy and Pitfalls

What Is Telemental Health?

The National Institute of Mental Health defines telemental health as “the use of telecommunications or videoconferencing technology to provide mental health services.” Telebehavioral healthcare refers to the process of observing behavior in a subject through online technologies. Telebehavioral health is considered a subgroup of telemental health. The U.S. Department of Health and Human Services says online visits are a convenient way for mental and behavioral health providers to offer:

• One-on-one and group therapy
• Substance abuse counseling
• Medication management
• Monitoring for anxiety and depression
• Mental health screening

Telemental health services enable clinicians to reach more patients, such as people who live in rural areas, those working irregular hours and homebound patients, according to the Anxiety and Depression Association of America.

Expanded access to online teletherapy during the pandemic may have inspired more adults to seek this type of care for the first time. Based on an analysis of private health insurance claims, Rand researchers found telemental health services provided to treat conditions such as depression, anxiety and post-traumatic stress disorder increased 10 to 20 percent between January and December 2020.

According to a 2021 American Psychiatric Association survey, nearly 60 percent of adults reported they were open to using telemental health services, and 43 percent said they would continue using those services after the pandemic ended.

EXPLORE: Best practices for linking mental health in the electronic health record.

What Are the Benefits of Telemental Health?

Kate Chard, a licensed psychologist and adjunct professor of psychiatry and behavioral neuroscience at the University of Cincinnati, says patients “love the option” of telemental care because it offers more flexibility than in-person visits. They save time because they don’t need to drive to the therapist’s office, and they may feel more comfortable opening up when they’re able to do so from the comfort of home, she says.

And it’s not just the patients who enjoy the flexibility. Chard says one of the biggest trends she’s seeing in telemental health is the number of providers who want to choose their hours and work from home. More than two-thirds of mental health facilities offer telehealth services, according to the Substance Abuse and Mental Health Services Administration.

“Technology helps us see patients more often” compared with in-person visits, Chard says, which can help some patients heal more quickly. “We’ve also found that PTSD patients are less likely to drop out of therapy when we use teletherapy.”

Chard adds, “One of the biggest benefits of telehealth for me is it increases the likelihood that the patient will show up for the appointment.” Research supports this idea: A study published in Psychiatric Quarterly concluded telehealth services reduce no-show rates, which benefits the provider from a fiscal standpoint. Missed appointments cost the U.S. healthcare system an estimated $150 billion annually.

What Technologies Are Needed to Support Telemental Health?

A secure internet connection and a video communication tool are the basic technologies needed to offer telemental health services. The Centers for Medicare and Medicaid Services recommends using video platforms that are HIPAA-compliant and willing to enter into HIPAA business associate agreements.

Shannon Houser, a professor in the Department of Health Services Administration at the University of Alabama at Birmingham, says working with an office administrative staff, including IT, is crucial to ensure there is adequate bandwidth and high-quality audio and video. These staff members can also help providers connect their telemental health tools and data to the electronic health record.

Digital literacy is a key component for implementing a solid telemental health program. “Not all providers are tech savvy,” Houser explains to HealthTech. “It’s important to set up training for clinicians so they understand how to use the technology to manage patient data.” 

She also advises having a system in place to educate patients about the technology in advance of a telehealth visit. “Office administrators can make sure patients feel comfortable and have the right tools for accessing the telehealth visits,” she says, which can help prevent cancellations or missed appointments.

READ MORE: Find out how to keep equity at the forefront in telehealth.

What Security Concerns Need to Be Addressed for Telemental Health?

Health systems should have standard security measures in place to protect patient privacy. In Perspectives in Health Information Management, Houser lists some of those measures as:

• Keeping anti-virus software updated
• Requiring passwords for online meetings
• Entering personal information only in secure sites, such as the electronic health record

Houser also suggests using the “waiting room” function on videoconference platforms before allowing the patient to join the online session. “We verify the patient’s information and make sure it’s really them,” she tells HealthTech.

To prevent strangers or even hackers from dropping in on a telemental health call, Chard says providers should always use a private link that is accessible to invited participants only.  “When we send a text or email directly to the patient, they can just click on the message to open it.”

Security codes add an extra layer of security. “Hackers can punch in numbers to try to access private calls,” Chard says. “But even if they find a private link, they can’t get in without the security code. It’s a dual system of protection.”