The COVID-19 pandemic drastically reshaped the landscape of behavioral health care, propelling tele-behavioral health services into the spotlight. Virtual mental health visits saw an unprecedented surge as patients and providers adapted quickly to the constraints imposed by the pandemic. According to Trilliant Health, tele-behavioral health trends reveal that in both April 2020 and April 2021, telehealth visit volumes were over 4,000% higher than in April 2019. This dramatic rise suggested a transformative shift in how mental health care could be accessed—offering hope for greater convenience, expanded reach, and reduced strain on traditional healthcare settings like emergency departments.
Yet, while tele-behavioral health visits soared, emergency department (ED) volumes for mental health conditions told a more complicated story. Despite the boom in virtual care, ED visits for mental health issues initially dropped early in the pandemic but then rose significantly in 2021, surpassing pre-pandemic levels. These tele-behavioral health trends demonstrate that virtual care, while impactful, is not a complete replacement for all behavioral health services. Understanding this nuanced dynamic is essential for healthcare providers, payers, investors, and policymakers aiming to optimize mental health care delivery in a post-pandemic world.
Early Pandemic Decline in Emergency Department Visits
In the early months of the pandemic, many emergency departments reported a marked decrease in visits related to mental health conditions. For instance, data from Trilliant Health shows that in April 2020, anxiety-related visits to EDs dropped by nearly 28%, and visits for severe psychiatric conditions such as schizophrenia, bipolar disorder, and major depressive disorder declined by about 25%, compared to April 2019. This drop was likely driven by several factors, including fears of contracting COVID-19 in hospital settings, stay-at-home orders, and the rapid transition toward telehealth services as a safer alternative.
Tele-behavioral health trends during this period clearly indicate that virtual care filled an important gap by providing continuity for many patients with mild to moderate mental health issues. This swift adoption of telehealth helped keep many individuals connected to care when in-person visits were not feasible. However, this decline in ED visits was temporary and did not signal a permanent reduction in the need for emergency behavioral health services.
The Rebound and Rise of Emergency Department Visits in 2021
By April 2021, emergency department visits for mental health conditions rebounded and, in many cases, exceeded pre-pandemic levels. Anxiety-related ED visits rose by nearly 9%, while visits related to schizophrenia, bipolar disorder, and major depressive disorder jumped by 35%, compared to April 2019. This surge occurred even as tele-behavioral health continued to be widely available.
These tele-behavioral health trends suggest that while virtual care expanded access and provided relief for many, it could not fully address the growing demand for acute and complex mental health care. The prolonged stressors of the pandemic—such as social isolation, economic uncertainty, and loss—likely exacerbated mental health conditions for many, leading to increased crisis episodes and a greater need for emergency interventions.
Moreover, some patients with severe psychiatric disorders require services that go beyond the scope of telehealth, including medication management, in-person assessments, hospitalization, and multidisciplinary care. This points to an important limitation: telehealth is an essential tool but not a comprehensive solution for all behavioral health needs.
Tele-behavioral Health as a Substitute Good: Understanding Its Role
Sanjula Jain, Chief Research and Market Strategy Officer at Trilliant Health, characterizes telehealth as a “substitute good” in the behavioral health market. From an economic standpoint, this means telehealth can replace certain traditional care services but does not completely substitute the need for in-person care—especially for complex and severe mental health cases.
Tele-behavioral health trends reflect this dynamic clearly. Virtual care is highly effective for patients with mild to moderate symptoms, providing timely therapy, counseling, and medication management. However, it often lacks the capacity to manage acute crises or severe psychiatric disorders that require immediate, hands-on intervention.
This insight underscores the necessity of integrating telehealth with other levels of care, including outpatient clinics, crisis stabilization units, and inpatient psychiatric facilities. Such integration ensures patients receive appropriate, timely interventions tailored to their condition’s severity and complexity.
Investment and Growth in the Digital Behavioral Health Market
The surge in tele-behavioral health adoption has not gone unnoticed by investors. In 2021 alone, digital behavioral health platforms attracted $5.5 billion across 324 deals—a staggering 1,000% increase in venture capital funding since 2015. Significant funding rounds included Lyra Health’s $200 million and Spring Health’s $190 million Series C, reflecting confidence in the sector’s growth potential.
These tele-behavioral health trends continued into 2022, with digital mental health companies securing $1 billion in funding during the first quarter. Lyra Health led once again with a $235 million Series F round. This investment enthusiasm signals the broader market’s belief in digital behavioral health as a critical component of future healthcare delivery.
However, experts like Jain caution that while funding is robust, stakeholders must maintain realistic expectations about telehealth’s role. The technology excels at improving access and convenience but may not be the ideal solution for patients with severe behavioral health needs who require comprehensive, high-touch care.
The Future of Tele-behavioral Health: Integration and Innovation
Tele-behavioral health trends show that virtual care is here to stay as a powerful and necessary part of behavioral health services. It offers unprecedented access, convenience, and scalability. Still, the continuing rise in emergency department visits for mental health conditions signals the importance of developing integrated, multi-modal care systems.
Looking ahead, healthcare organizations and policymakers should focus on creating hybrid models that combine the strengths of telehealth with in-person emergency and outpatient services. This could involve enhanced crisis response teams, better care coordination technologies, and personalized care pathways that match patients’ unique needs.
Innovation in tele-behavioral health may also include AI-driven triage tools, remote monitoring, and virtual peer support networks—all designed to complement traditional care and reduce the burden on emergency services. By leveraging these trends thoughtfully, the behavioral health ecosystem can evolve to deliver more effective, patient-centered care.
Conclusion
Tele-behavioral health trends reflect a significant transformation in how mental health care is accessed and delivered. The pandemic accelerated adoption, proving virtual care’s value, but also exposed its limitations. Rising emergency department visits for severe behavioral health conditions highlight the continued need for comprehensive, integrated care models.
For investors, providers, and policymakers, the path forward involves balancing the promise of telehealth with the realities of complex patient needs. By embracing a holistic approach that combines tele-behavioral health with robust in-person services, the healthcare system can better support individuals across the full spectrum of mental health challenges.
