Journal of Rural Mental Health, Vol 48(4), Oct 2024, 219-229; doi:10.1037/rmh0000269
The dramatic surge in tele-mental health (TMH) utilization during the COVID-19 Public Health Emergency (PHE) brings forth concerns about its sustainability. This study scrutinizes TMH trends and sociodemographic characteristics of urban and rural patients during the PHE. We analyzed TMH outpatient utilization from January 1, 2020, to June 30, 2023, at the academic medical center in Mississippi and compared the sociodemographic characteristics of TMH patients between the early and later COVID-19 periods. TMH encounters followed a similar trend across urban and rural settings, with varying shift magnitudes. Quarter 2 (Q2) 2020 saw a sharp increase in TMH utilization among adults (urban: 993%, rural: 880%) and pediatrics (urban: 1,076%, rural: 1,212%). In the early COVID-19 period (Quarter 1 [Q1]–Q2 2020), 1,841 adult and 513 pediatric patients accessed TMH services, and in the later period (Q1–Q2 2023), 542 adult and 101 pediatric patients did. The proportion of rural adult TMH patients increased from 23.80% to 29.34% and pediatric patients from 29.43% to 46.53%. Distinct shifts in primary payment methods and household incomes were observed among TMH patients, including a discernible increase in the other payment methods among urban TMH patients, compared to their rural counterparts, and a decrease in Medicaid coverage for rural pediatric patients. This study unveils evolving patterns of TMH utilization and associated sociodemographic changes during COVID-19. The multifaceted sociodemographic shifts highlight the need for adaptable, affordable, and inclusive TMH services and policies to ensure equitable mental health care access in the postpandemic era. (PsycInfo Database Record (c) 2024 APA, all rights reserved)