{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T20:54:16Z","timestamp":1785099256350,"version":"3.55.0"},"reference-count":16,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240669-4\"><jats:title>Importance<\/jats:title><jats:p>Telehealth services expanded rapidly during the COVID-19 public health emergency (PHE).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240669-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate changes in availability of telehealth services at outpatient mental health treatment facilities (MHTFs) throughout the US during and after the COVID-19 PHE.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240669-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this cohort study, callers posing as prospective clients contacted a random sample of 1404 MHTFs drawn from the Substance Abuse and Mental Health Services Administration\u2019s Behavioral Health Treatment Locator from December 2022 to March 2023 (wave 1 [W1]; during PHE). From September to November 2023 (wave 2 [W2]; after PHE), callers recontacted W1 participants. Analyses were conducted in January 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240669-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Callers inquired whether MHTFs offered telehealth (yes vs no), and, if yes, whether they offered (1) audio-only telehealth (vs audio and video); (2) telehealth for therapy, medication management, and\/or diagnostic services; and (3) telehealth for comorbid alcohol use disorder (AUD). Sustainers (offered telehealth in both waves), late adopters (did not offer telehealth in W1 but did in W2), nonadopters (did not offer telehealth in W1 or W2), and discontinuers (offered telehealth in W1 but not W2) were all compared.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240669-8\"><jats:title>Results<\/jats:title><jats:p>During W2, 1001 MHTFs (86.1%) were successfully recontacted. A total of 713 (71.2%) were located in a metropolitan county, 151 (15.1%) were publicly operated, and 935 (93.4%) accepted Medicaid as payment. The percentage offering telehealth declined from 799 (81.6%) to 765 (79.0%) (odds ratio [OR], 0.84; 95% CI, 0.72-1.00; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.05). Among MHTFs offering telehealth, a smaller percentage in W2 offered audio-only telehealth (369 [49.3%] vs 244 [34.1%]; OR, 0.53; 95% CI, 0.44-0.64; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and telehealth for comorbid AUD (559 [76.3%] vs 457 [66.5%]; OR, 0.62; 95% CI, 0.50-0.76; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) compared with W1. In W2, MHTFs were more likely to report telehealth was only available under certain conditions for therapy (141 facilities [18.0%] vs 276 [36.4%]; OR, 2.62; 95% CI, 1.10-3.26; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and medication management (216 facilities [28.0%] vs 304 [41.3%]; OR, 1.81; 95% CI, 1.48-2.21; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). A total of 684 MHTFs (72.0%) constituted sustainers, 94 (9.9%) were discontinuers, 106 (11.2%) were nonadopters, and 66 (7.0%) were late adopters. Compared with sustainers, discontinuers were less likely to be private for-profit (adjusted OR [aOR], 0.28; 95% CI, 0.11-0.68) or private not-for-profit (aOR, 0.26; 95% CI, 0.14-0.48) after adjustment for facility and area characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240669-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Based on this longitudinal cohort study of 1001 MHTFs, telehealth availability has declined since the PHE end with respect to scope and modality of services, suggesting targeted policies may be necessary to sustain telehealth access.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.20853","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:03:52Z","timestamp":1720623832000},"page":"e2420853","source":"Crossref","is-referenced-by-count":20,"title":["Telehealth Availability for Mental Health Care During and After the COVID-19 Public Health Emergency"],"prefix":"10.1001","volume":"7","author":[{"given":"Ryan K.","family":"McBain","sequence":"first","affiliation":[{"name":"Division of Healthcare Delivery, RAND, Washington, DC"},{"name":"Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan S.","family":"Schuler","sequence":"additional","affiliation":[{"name":"Division of Healthcare Delivery, RAND, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Breslau","sequence":"additional","affiliation":[{"name":"Division of Healthcare Delivery, RAND, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Kofner","sequence":"additional","affiliation":[{"name":"Division of Healthcare Delivery, RAND, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine, Georgetown University, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Cantor","sequence":"additional","affiliation":[{"name":"Division of Healthcare Delivery, RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"issue":"6","key":"zoi240669r1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.18045","article-title":"Expansion of telehealth availability for mental health care after state-level policy changes from 2019 to 2022.","volume":"6","author":"McBain","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"12","key":"zoi240669r2","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1001\/jamapsychiatry.2022.3330","article-title":"Implications of telepsychiatry for cost, quality, and equity of mental health care.","volume":"79","author":"Blanco","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"23","key":"zoi240669r3","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1001\/jama.2020.7943","article-title":"Implications for telehealth in a postpandemic future: regulatory and privacy issues.","volume":"323","author":"Shachar","year":"2020","journal-title":"JAMA"},{"issue":"8","key":"zoi240669r11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.13456","article-title":"Association of pregnancy and insurance status with treatment access for opioid use disorder.","volume":"3","author":"Patrick","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"8","key":"zoi240669r12","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1001\/jama.2020.8969","article-title":"Therapies offered at residential addiction treatment programs in the United States.","volume":"324","author":"Beetham","year":"2020","journal-title":"JAMA"},{"key":"zoi240669r13","doi-asserted-by":"publisher","DOI":"10.1108\/JSTPM-08-2021-0126","article-title":"A review of telehealth during the COVID-19 emergency situation in the public health sector: challenges and opportunities.","author":"Maleka","year":"2022","journal-title":"J Sci Tech Pol Manage"},{"issue":"12","key":"zoi240669r14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000401","article-title":"Telehealth and digital health innovations: a mixed landscape of access.","volume":"2","author":"Phuong","year":"2023","journal-title":"PLOS Digit Health"},{"issue":"4","key":"zoi240669r15","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1097\/MLR.0000000000001512","article-title":"Availability of outpatient telemental health services in the United States at the outset of the COVID-19 pandemic.","volume":"59","author":"Cantor","year":"2021","journal-title":"Med Care"},{"key":"zoi240669r4","unstructured":"Chu? RC, Peters? C, Lew? ND, Sommers? BD. State Medicaid telehealth policies before and during the COVID-19 public health emergency. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. 2021. Accessed June 5, 2024. https:\/\/aspe.hhs.gov\/sites\/default\/files\/documents\/eb9e147935a2663441a9488e36eea6cb\/medicaid-telehealth-brief.pdf"},{"key":"zoi240669r5","unstructured":"Department of Health and Human Services. Telehealth policy changes after the COVID-19 public health emergency. January 19, 2023. Accessed January 30, 2024. https:\/\/telehealth.hhs.gov\/providers\/telehealth-policy\/policy-changes-after-the-covid-19-public-health-emergency"},{"key":"zoi240669r6","unstructured":"American Academy of Family Physicians. Telehealth after the COVID-19 PHE: what\u2019s changing, and what\u2019s staying the same for now. 2023. Accessed May 2, 2024. https:\/\/www.aafp.org\/pubs\/fpm\/blogs\/inpractice\/entry\/covid-phe-end-telehealth.html#:~:text=The%20originating%20and%20geographic%20site,to%20a%20health%20care%20facility"},{"key":"zoi240669r7","unstructured":"Centers for Medicare and Medicaid Services. Telehealth Services. 2024. Accessed June 5, 2024. https:\/\/www.cms.gov\/files\/document\/mln901705-telehealth-services.pdf"},{"key":"zoi240669r8","unstructured":"Substance Abuse and Mental Health Services Administration. FindTreatment.gov. 2023. Accessed June 3, 2023. https:\/\/findtreatment.gov\/"},{"key":"zoi240669r9","unstructured":"Substance Abuse and Mental Health Services Administration. SAMHSA behavioral health treatment services locator. 2022. Accessed May 17, 2022. https:\/\/findtreatment.samhsa.gov\/locator\/about.html#.YoOJ5-hlA2w"},{"key":"zoi240669r10","unstructured":"Health Resources and Services Administration. Area health resources files. 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Accessed May 2, 2024. https:\/\/www.kff.org\/mental-health\/issue-brief\/telehealth-delivery-of-behavioral-health-care-in-medicaid-findings-from-a-survey-of-state-medicaid-programs\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2820968\/mcbain_2024_oi_240669_1719929580.1504.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:03:59Z","timestamp":1720623839000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2820968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.20853","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]}}}