The COVID-19 pandemic rapidly reshaped how health care is delivered, ushering in a wave of innovation. One of the most dramatic shifts occurred in telehealth in behavioral health care, where services once bound by geography and scheduling limitations suddenly became accessible from almost anywhere. During a time of crisis, providers and patients adapted fast—and discovered that virtual care can be just as impactful as in-person visits.
According to Dr. Kari Law, telepsychiatry program director and clinical operations vice chair for the West Virginia University Department of Behavioral Medicine and Psychiatry, virtual behavioral health visits surged by 429% in 2020 alone. Even now, about 55% of appointments remain virtual. These numbers aren’t just temporary trends; they represent a significant redefinition of how mental health and substance use care can be delivered more equitably.
Yet the continued growth and sustainability of telehealth in behavioral health care face serious obstacles. From outdated regulations and technology gaps to rural access and digital equity, the field stands at a crossroads. Without action from federal agencies and the collective voice of advocates, the gains made during the pandemic risk being reversed.
How Telehealth in Behavioral Health Care Changed the Game
At its core, telehealth in behavioral health care has proven to be more than just a convenient alternative—it’s become a vital solution to long-standing access problems. Traditionally, behavioral health services required individuals to travel, take time off work, arrange child care, and navigate a shortage of in-person providers. For patients living in rural or underserved communities, these barriers often made care impossible.
Dr. Law highlighted how telehealth offers relief for many of these pain points. “For folks who live in an area that’s either financially or geographically limited in resources, it’s unethical not to provide those services,” she said. And with half of West Virginia’s population residing in rural areas, the need is urgent.
This flexibility also supports those with nonclinical challenges—like individuals reintegrating after incarceration, parents juggling multiple jobs, and patients experiencing housing instability. Telehealth meets people where they are, making care more consistent and less stigmatized.
Broadband and Tech Access: The Modern Divide
Even as telehealth in behavioral health care expands, not all communities have equal access to it. Broadband availability is a fundamental barrier, especially in rural regions like West Virginia or Native communities served by Indian Health Services (IHS). While around 76% of rural households in West Virginia have internet, that still leaves nearly a quarter unable to reliably connect with providers.
Chris Fore, director of the IHS TeleBehavioral Health Center of Excellence, pointed out that the infrastructure simply isn’t robust enough in many regions. “The digital divide in Indian Country is real,” he said. Many patients lack both high-speed internet and modern devices capable of handling video-based care. As a result, about 80% of behavioral health visits for IHS patients in 2020 were conducted via phone, not video.
This is a stark reminder that expanding telehealth in behavioral health care isn’t just about software platforms or trained clinicians—it’s also about ensuring every community has the tools to access care with dignity and reliability.
Pandemic-Era Policies That Enabled Growth
The rapid adoption of telehealth in behavioral health care during COVID-19 didn’t happen by chance—it was enabled by a series of regulatory adjustments. The federal government relaxed rules around telehealth prescribing (including under the Ryan Haight Act), allowed cross-state services in some cases, and ensured reimbursement parity in many scenarios.
These flexibilities opened the door for providers to reach more people, prescribe medications virtually, and deliver continuous care during a time of global disruption. But many of these policies were tied directly to the COVID-19 public health emergency, and their expiration looms.
Without permanent legislative changes, providers may lose the ability to prescribe certain medications virtually or serve patients across state lines. These setbacks could dramatically reduce access—especially for patients who rely on consistent, virtual interactions with specialized professionals.
Why Advocacy Matters More Than Ever
Leaders like Dr. Law and Margaret Howard, division director at the Center for Women’s Behavioral Health and professor at Brown University, emphasize the urgent need for collective advocacy. “It cannot be understated how valuable our voices and our patients’ voices are,” Law said. Howard echoed, “We have to be very loud with all of our collective voices.”
The message is clear: to preserve the progress made in telehealth in behavioral health care, stakeholders must advocate for:
- permanent flexibility around virtual prescribing
- consistent reimbursement rates between in-person and virtual services
- cross-state licensure options for mental health professionals
- federal and state investments in broadband and tech access
- greater support for device equity in rural and underserved areas
These are not luxuries—they are essentials to keep care flowing to those who need it most.
Real-Life Impact on Providers and Patients
As providers pivoted away from in-clinic care, the benefits and challenges became crystal clear. Patients began showing up more consistently, often reporting fewer anxiety triggers when attending sessions from home. Clinicians could stretch their services across broader regions, helping people who would otherwise wait weeks or months for a local provider.
However, not every transition was seamless. For some, video calls were inaccessible due to lack of bandwidth, leading to phone-only sessions with limited effectiveness. Others struggled with privacy, attending therapy from crowded or unstable home environments.
This mixed reality of telehealth in behavioral health care illustrates the urgency of making telehealth not just widely available, but genuinely functional for every type of patient situation.
Looking Ahead: The Future We Must Build
The momentum around telehealth in behavioral health care cannot be allowed to fade. The pandemic showed us what’s possible—now we need to ensure it lasts. That means crafting public policy around accessibility, infrastructure, and inclusivity. It means updating laws to reflect modern patient behaviors and expectations. And it means continuing to innovate how virtual care is delivered to diverse populations.
We’ve seen what works. The challenge now is protecting and scaling it.
The future of telehealth in behavioral health care depends on coordinated action, not passive observation. It depends on policymakers listening to those on the ground—clinicians, patients, and families. And it depends on systems that prioritize care continuity over outdated rules.
Final Thoughts: Don’t Let the Door Close
Telehealth in behavioral health care transformed access, broke down walls, and reached communities often left behind. But without smart policy, solid infrastructure, and strong advocacy, the door opened by the pandemic may slowly close again.
This isn’t a conversation about convenience—it’s a conversation about care equity. Whether you’re a policymaker, a provider, or a patient, your voice can help shape the next chapter of behavioral health in the U.S.
Now is the time to speak up, act boldly, and ensure virtual care remains not just available, but accessible and effective for all.
