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. 2023 Nov:329:115497.
doi: 10.1016/j.psychres.2023.115497. Epub 2023 Sep 24.

Engagement of individuals with serious mental illness in outpatient mental health services and telehealth use during the COVID-19 pandemic

Natalie Bareis  1 , Miriam C Tepper  2 , Rui Wang  3 , Fei Tang  3 , Mark Olfson  4 , Lisa B Dixon  2 , David Kimhy  5 , Melanie M Wall  4 , Alice Medalia  2 , Molly T Finnerty  3 , Adrienne Anderson  3 , Thomas E Smith  6
Affiliations

Engagement of individuals with serious mental illness in outpatient mental health services and telehealth use during the COVID-19 pandemic

Natalie Bareis et al. Psychiatry Res. 2023 Nov.

Abstract

Questions remain regarding whether the transition and continued use of telehealth was associated with changes in treatment engagement among patients with serious mental illness (SMI). Using NYS Medicaid claims, we identified 116,497 individuals with SMI receiving outpatient mental health services from September 1, 2019-February 28, 2021 and a comparison cohort of 101,995 from September 1, 2017-February 28, 2019 to account for unmeasured and seasonal variation. We characterized engagement in three 6-month increments (T0-T1-T2) using clinically meaningful measures of high, partial, low, and none. Subgroup differences were compared, and telehealth users were compared to those with only in-person visits. Engagement, as characterized, was largely maintained during COVID. The 19.0 % with only in-person visits during COVID had different characteristics than telehealth users. Telehealth use was greater among younger people by T2 (33.1 %), women (57.7 %), non-Hispanic White people (38.9 %), and those with MDD (18.0 %), but lower among non-Hispanic Black people, in NYC, and those with schizophrenia or SUD. Most telehealth users were highly engaged (77.1 %); most using only in-person services had low engagement (47.5 %). The shift to telehealth preserved access to many outpatient services for this SMI population. Exploring reasons for not using telehealth may identify opportunities to increase care access.

Keywords: Mental health services; Outpatient services; Serious mental illness; Substance use disorder; Telehealth; Telemedicine; Virtual mental health services.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
a. COVID Cohort flow of engagement in care over time b. Comparison Cohort flow in engagement in care over time
Figure 1.
Figure 1.
a. COVID Cohort flow of engagement in care over time b. Comparison Cohort flow in engagement in care over time
Figure 2.
Figure 2.
Telehealth Use during COVID-19 Timepoints by Mental Health Service Engagement Categories (High, Partial, Low, None).
See this image and copyright information in PMC

References

    1. Ainslie M, Brunette MF, & Capozzoli M (2022). Treatment Interruptions and Telemedicine Utilization in Serious Mental Illness: Retrospective Longitudinal Claims Analysis. JMIR Ment Health, 9(3), e33092. 10.2196/33092 - DOI - PMC - PubMed
    1. Busch AB, Huskamp HA, Raja P, Rose S, & Mehrotra A (2022). Disruptions in Care for Medicare Beneficiaries With Severe Mental Illness During the COVID-19 Pandemic. JAMA Netw Open, 5(1), e2145677. 10.1001/jamanetworkopen.2021.45677 - DOI - PMC - PubMed
    1. Cantor J, McBain RK, Kofner A, Hanson R, Stein BD, & Yu H (2022). Telehealth Adoption by Mental Health and Substance Use Disorder Treatment Facilities in the COVID-19 Pandemic. Psychiatr Serv, 73(4), 411–417. 10.1176/appi.ps.202100191 - DOI - PMC - PubMed
    1. Cantor JH, McBain RK, Ho PC, Bravata DM, & Whaley C (2023). Telehealth and In-Person Mental Health Service Utilization and Spending, 2019 to 2022. JAMA Health Forum, 4(8), e232645. 10.1001/jamahealthforum.2023.2645 - DOI - PMC - PubMed
    1. Connolly SL, Stolzmann KL, Heyworth L, Sullivan JL, Shimada SL, Weaver KR, Lindsay JA, Bauer MS, & Miller CJ (2022). Patient and provider predictors of telemental health use prior to and during the COVID-19 pandemic within the Department of Veterans Affairs. Am Psychol, 77(2), 249–261. 10.1037/amp0000895 - DOI - PMC - PubMed

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