When the COVID-19 pandemic swept across the United States in early 2020, behavioral health organizations were faced with a daunting challenge: how to continue delivering essential care while minimizing the risk of virus transmission. Almost overnight, treatments that had traditionally been provided in person were transitioned to virtual platforms. Thanks to federal and state flexibilities, providers were able to quickly pivot their operations and embrace telehealth as a primary mode of care.
Now, even as the nation continues to adapt to a post-pandemic reality, a significant portion of this shift to virtual care is here to stay. According to a survey conducted by the National Council for Behavioral Health and Qualifacts, an electronic health record (EHR) provider, 70% of behavioral health and human services organizations plan to continue delivering at least 40% of their services virtually.
A Rapid Shift to Virtual Care
Before the pandemic, the use of telehealth in behavioral health was minimal. Only about 3% of providers reported delivering a significant portion of their services remotely. In-person visits dominated the industry, particularly for therapies, medication management, and group sessions.
That all changed in March 2020. With COVID-19 spreading rapidly, telehealth quickly became a lifeline for patients and providers alike. The survey revealed that during the height of the pandemic, more than 60% of organizations were delivering at least 80% of their care virtually. This dramatic increase ensured continuity of care for patients, reduced no-show rates, and allowed providers to maintain critical services amid widespread lockdowns.
The Benefits of Telehealth in Behavioral Health
The rise of telehealth has demonstrated several key benefits for patients and providers. Accessibility is at the top of the list. Many patients who previously faced barriers such as transportation issues, mobility challenges, or living in rural areas were able to connect with their providers more easily through virtual platforms.
Telehealth also reduced stigma. Some individuals hesitant to walk into a mental health clinic felt more comfortable seeking support from the privacy of their own homes. Additionally, telehealth often resulted in fewer missed appointments, as patients could log in quickly without needing to rearrange their schedules or take time off work.
For providers, the ability to reach a broader patient population helped mitigate some of the disruptions caused by the pandemic. However, while telehealth expanded access and kept care moving forward, it did not come without significant financial challenges.
Revenue Declines During the Pandemic
Despite the success of virtual care delivery, the survey highlighted that 64% of providers experienced reduced revenue during the pandemic. Inpatient programs were hit particularly hard, as they often represent the most profitable service lines for organizations.
Providers who serve patients with intellectual and developmental disabilities also faced steep financial losses. Many of these programs had to completely shutter their campuses, resulting in not only an immediate loss of income but also uncertainty about the costs of reopening, rehiring, and re-onboarding furloughed staff.
This financial strain underscored the need for new strategies to ensure the sustainability of behavioral health organizations, especially as telehealth becomes a permanent fixture in the industry.
The Future of Telehealth in Behavioral Health
Looking ahead, the survey found that while providers plan to maintain significant use of telehealth, the levels will not remain as high as they were during the peak of the pandemic. Instead, a hybrid model of care is expected to dominate, blending in-person and virtual services based on patient needs and clinical appropriateness.
To make this transition sustainable, organizations will need to address several key challenges. One of the most pressing is technology. Many providers will need to invest in telehealth platforms that fully comply with state and federal regulations, particularly as temporary flexibilities granted during the pandemic begin to expire.
In fact, 20% of survey respondents indicated they may need to change EHR vendors to support their virtual care offerings. This highlights the importance of reliable, integrated systems that can handle the complexities of hybrid service delivery.
Policy and Parity Considerations
The future of telehealth also depends heavily on policy. During the pandemic, emergency measures allowed for expanded telehealth reimbursement, cross-state licensure flexibility, and broader use of digital platforms. If these policies are rolled back, it could pose significant challenges for behavioral health providers.
Parity laws — which require insurers to cover mental health care at the same level as physical health care — will also play a crucial role. Ensuring that telehealth visits are reimbursed fairly and consistently is essential for long-term viability. Without financial support and regulatory clarity, many providers could struggle to maintain virtual care at the levels patients now expect.
Meeting Patient Needs in a Changing Landscape
Patients have grown accustomed to the convenience of telehealth, and many are unlikely to want to return fully to pre-pandemic care models. Behavioral health organizations will need to adapt their services to meet these evolving expectations.
Hybrid care models can offer the best of both worlds. For example, initial evaluations or complex cases may still require in-person visits, while follow-up appointments, group sessions, and medication management can often be handled virtually. By tailoring services to patient needs, providers can maximize outcomes while also optimizing resources.
Building a Sustainable Future
The COVID-19 pandemic accelerated a shift in behavioral health care that was already on the horizon. Telehealth is no longer a temporary solution but an integral part of the treatment landscape. However, sustaining this progress will require investment, innovation, and collaboration among providers, policymakers, payers, and technology partners.
Organizations must continue advocating for supportive policies, parity in reimbursement, and expanded access to broadband internet — especially in rural and underserved areas where connectivity remains a barrier. They must also train their staff to deliver high-quality virtual care and ensure that platforms are user-friendly for patients of all ages and backgrounds.
Conclusion
The survey by the National Council for Behavioral Health and Qualifacts offers a clear message: telehealth is here to stay. While behavioral health organizations will not maintain the extraordinary levels of virtual care seen during the height of the pandemic, 70% plan to deliver at least 40% of services virtually moving forward.
This represents a permanent transformation in the way behavioral health care is delivered. By embracing hybrid models, investing in technology, and advocating for supportive policies, providers can ensure that patients continue to receive the care they need — whether in person or online.
The pandemic may have forced behavioral health organizations to innovate out of necessity, but the long-term result is a more flexible, accessible, and patient-centered system of care.
