Study Targets Benefits of Asynchronous Telehealth for Mental Health Care

New research out of the University of California Davis finds that telehealth treatments for people with non-urgent mental health needs can be delivered via an asynchronous (store-and-forward) platform just as well as through an audio-visual platform.

A study publishing online last month in the Journal of Medical Internet Research (JMIR) indicates patients using either asynchronous or synchronous telemedicine technology to meet with psychiatrists saw no significant difference in improvements – though both “had statistically and clinically significant improvements” in treatment outcomes over the five-year study.

The research is important at a time when the healthcare industry is striving to address barriers to access, including social determinants of health. Many see connected health as a vital platform to help people who can’t or won’t seek in-person treatment, but many – particularly those in rural and underserved communities – lack the resources to connect with a care provider.

The UC Davis study compares the so-called “gold standard” to telehealth – a platform that includes audio and video capabilities – with a platform that allows a patient to answer questions online and submit them to a care provider, who reviews the answers and sends a diagnosis and treatment plan back within a v=certain amount of time.

Federal and state lawmakers are taking a renewed interest in asynchronous telehealth as a means of reaching underserved populations, especially in light of the challenges created by the pandemic. Access to mental health services is especially crucial at this time, owing to an increase in people dealing with stress, anxiety, depression and substance abuse and a nationwide shortage of care providers.

In several states, lawmakers have revised the rules to allow providers to use platforms like asynchronous and audio-only telehealth, particularly for access to mental health services. This allows providers to use online portals, questionnaires and even the telephone to connect with patients who don’t have access to real-time video connections.

The UC Davis study focused on roughly 400 people seeking treatment for depression or anxiety across a five-year period at three primary care clinics supporting some 36 primary care physicians. Of that group, 184 patients, both English- and Spanish-speaking, were enrolled in the study. They were treated by their PCPs in consultation with psychiatrists from UC Davis Health, who met with the patients every six months for up to two years, using either a synchronous and asynchronous telehealth platform, and then made treatment recommendations to the PCPs.

The study was led by Peter Yellowlees, MD, MBBS, a psychiatrist and researcher with UC Davis Health, an expert in telemental health and a former president of the American Telemedicine Association.

“This is the first longitudinal study to demonstrate that ATP (asynchronous telepsychiatry) can improve clinical outcomes in English and Spanish speaking primary care patients,” Yellowlees and his colleagues concluded in their study. “Although we did not find evidence that ATP is superior to STP (synchronous telepsychiatry) in improving clinical outcomes, it is potentially a key part of stepped mental health interventions available in primary care. ATP presents a possible solution to the workforce shortage of psychiatrists and a strategy for improving existing systems of care.”