Telehealth has moved from being an emergency response tool during the COVID-19 pandemic to a mainstream component of behavioral health care. Its widespread adoption has transformed how mental health and addiction services are delivered, offering patients unprecedented access and convenience. Today, telehealth mental health services are an essential part of modern care, helping millions of patients connect with clinicians regardless of location.
The Rise of Telehealth in Behavioral Health
The onset of the pandemic forced rapid innovation across healthcare systems, and behavioral health was no exception. With in-person visits limited by social distancing and lockdown measures, providers and patients turned to telehealth out of necessity. What began as a stopgap measure quickly demonstrated lasting value.
According to data from the nonprofit health claims clearinghouse Fair Health, mental health care now represents 41% of commercial and Medicare telehealth claims, with mental health included in 63% of all diagnoses. These figures reflect not only the high demand for behavioral health services but also the flexibility and accessibility of telehealth mental health services for patients who may otherwise face barriers such as transportation challenges, scheduling conflicts, or provider shortages.
Dr. Tisamarie Sherry, deputy assistant secretary for planning and evaluation at the Office of Behavioral Health, Disability and Aging Policy (ASPE), emphasized that telehealth mental health services are “here to stay.” She noted that while the technology itself has demonstrated staying power, the future of telehealth depends on thoughtful policy and data-driven decisions about optimal delivery models.
Regulatory Challenges and the Risk of Substandard Care
While telehealth adoption has skyrocketed, its regulatory framework is still catching up. A panel at the Behavioral Health & Well-Being Congress highlighted a paradox in telehealth regulation: placing too many restrictions on telehealth could inadvertently make it a second-class care modality.
Chris Adamec, vice president at the advocacy group Alliance for Connected Care, explained, “We are in a chicken and egg situation where if we’re concerned about telehealth and we put a bunch of restrictions on it … we create the situation we were worried about, because then telehealth becomes substandard care and can’t be equal to in-person care.”
Potential regulations around prescribing medications, interacting with new patients, and maintaining certain compliance requirements could limit the utility of telehealth mental health services, often based on unfounded concerns. Adamec warned that “without adequate data, we make rash policies that undermine the ability of clinicians to practice through telehealth.”
Telehealth’s Impact on Access and Patient Outcomes
Telehealth has already demonstrated measurable benefits for patients, providers, and the healthcare system at large. The Office of Inspector General for the U.S. Health and Human Services Department found that 43% of behavioral health visits for Medicare beneficiaries were conducted via telehealth from March 2020 to February 2021, accounting for roughly 12% of all telehealth visits regardless of care type.
Shelley Doumani-Semino, senior behavioral health medical director for Aetna, noted several positive impacts of telehealth mental health services on behavioral health care. These include:
- Lower no-show rates: Patients are more likely to attend appointments when they can connect from home.
- Higher retention in treatment programs: Telehealth facilitates ongoing engagement, especially for patients with chronic conditions or substance use disorders.
- Improved medication adherence: Remote check-ins help ensure patients follow treatment plans.
- Reduced treated overdoses: Increased access to timely behavioral health care can prevent crises.
For patients with addiction or co-occurring disorders, telehealth mental health services have been indispensable. Doumani-Semino emphasized the anxiety some patients experience about potential regulatory changes. “I have patients who are already talking to me about what happens when this goes away,” she said. “No one likes to see that anxiety in patients … I hate to see them starting to worry about their treatment because if I have to close my panel of patients down, where are they going to go? There just are not enough practitioners who can pick up this treatment.”
Challenges That Remain
Despite these benefits, telehealth mental health services face challenges. Regulatory ambiguity, technology access, and reimbursement parity are key concerns. Many temporary waivers put in place during the federal public health emergency facilitated adoption, but questions remain about which should remain permanent. Patients without reliable internet or devices may still be left behind, creating new disparities in access to care.
Additionally, certain aspects of behavioral health care—such as random drug testing or physical assessments—remain difficult to conduct virtually. Without proper reimbursement policies, providers may be forced to limit telehealth mental health services, reducing access for patients who have come to rely on them.
The Importance of Data and Research
A recurring theme from the Behavioral Health & Well-Being Congress panel was the need for robust data to guide telehealth policy. While early studies indicate that telehealth improves access, engagement, and outcomes, widespread adoption is relatively recent. There are still many unanswered questions about optimal delivery models, patient preferences, and long-term clinical outcomes.
Dr. Sherry stressed that the current period is a transition. “What needs to help inform that transition going forward is some evidence to guide us about what’s the optimal delivery model to do this,” she said. Careful study of telehealth mental health services will be essential to shaping regulations that support, rather than hinder, access and quality.
Telehealth and Medicare
The federal government has a particular interest in telehealth mental health services because of their impact on Medicare beneficiaries. Telehealth has become critical for maintaining access to behavioral health services among older adults, many of whom face mobility challenges or live in areas with limited provider availability. Ensuring telehealth remains accessible for this population is vital for continuity of care and overall safety.
A Path Forward
The lessons from the pandemic are clear: telehealth mental health services work, patients and providers like them, and they improve access to essential behavioral health services. However, for telehealth to reach its full potential, careful attention must be paid to regulations, reimbursement, and research. Policies must ensure safety and quality without imposing unnecessary restrictions that could create substandard care scenarios.
Key steps for the future include:
- Maintaining regulatory flexibility: Avoid overly restrictive rules that limit provider options or patient access without evidence of benefit.
- Investing in research: Long-term studies on clinical outcomes, patient satisfaction, and delivery models will inform sustainable telehealth policies.
- Ensuring reimbursement parity: Telehealth must be reimbursed at rates comparable to in-person care.
- Expanding technology access: Closing the digital divide is essential for equitable access.
- Addressing provider workforce challenges: Ensuring enough trained professionals can offer telehealth services is critical.
Conclusion
Telehealth has proven itself as more than a temporary solution—it is a permanent, evolving part of behavioral health care. Its adoption has improved access, engagement, and outcomes while providing clinicians with the tools to extend care beyond the traditional office setting.
The question is no longer whether telehealth mental health services will remain part of behavioral health—it is how they will evolve to best meet the needs of patients and providers alike. Decisions made today will shape the future of mental health care for years to come.
