Anxiety Disorder Patients Used Telehealth More During Pandemic

A greater proportion of people with anxiety and fear-based mental health disorders received care through telehealth rather than in-person in 2020, a new study shows.  

People with anxiety and fear-related disorders tended to use telehealth more than in-person visits when seeking mental healthcare in the first year of the COVID-19 pandemic, according to a recent study.

Conducted by researchers at the Oregon Health & Science University, the study was published in Health Affairs. The retrospective analysis used data from claims clearinghouse Office Ally to compare outpatient mental health services from March 2016 to December 2018 with services during the same period in 2020.

Researchers studied 101.7 million outpatient mental health visits in total. The visits involved people 12 years and older with primary diagnosis codes corresponding to mental health conditions and encounters categorized as in-person or telehealth.

In the early months of the pandemic, in-person mental health visits fell by 21.9 percent. But they rebounded, with nearly half (47.9 percent) transitioning to telehealth by the end of December 2020.

"Our study suggests that telehealth services for mental health counseling expanded significantly and is likely to stay," said lead author Jane Zhu, MD, an assistant professor of medicine in the OHSU School of Medicine, in a press release.

Researchers also found that the degree to which telehealth use increased across clinical subgroups varied. For example, a larger proportion of people with schizophrenia opted for in-person visits (2.7 percent) as compared with telehealth encounters (1.7 percent). But more people with anxiety and fear-related disorders used telehealth (27.5 percent) than in-person care (25.5 percent).

Not only that, but older adults, Black and Hispanic people, people living alone, and those with lower incomes also appeared to be less likely to access mental health counseling via telehealth.

"Telemedicine is often talked about as the next frontier of healthcare delivery," Zhu said. "Yet, the evidence in our paper suggests a lack of uptake among some groups who are experiencing barriers to telehealth."

Thus, telemental healthcare providers should focus on understanding the nuances of usage, including the demographics and types of mental health conditions best suited for virtual care, she said.

The use of virtual mental healthcare has grown, even as COVID-19 cases ebbed and flowed over the course of the pandemic. Outpatient visits that relate to mental health or substance use diagnoses increased from 11 percent in 2019 to 39 percent in 2021, according to data from the Kaiser Family Foundation.

Federal data shows that receiving mental health services via telehealth was also popular among older adults early in the pandemic. Medicare beneficiaries received 14.1 million behavioral health services, like individual therapy and substance use disorder treatment, through telehealth in 2020.

Additionally, mental health patients are becoming increasingly comfortable with receiving care virtually.

More than half of Millennial and Gen Z respondents to a recent survey said they were equally comfortable with virtual and in-person therapy. Similarly, 45 percent of Baby Boomers and 55 percent of Generation X respondents said they were equally comfortable with both types of therapy.

Lawmakers have taken note of virtual mental healthcare's popularity. Recently, three senators introduced a bill that aims to increase access to telemental healthcare for children and underserved populations.