{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:19:15Z","timestamp":1780337955811,"version":"3.54.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mental health issues disproportionately affect rural and low-income populations, where access to prevention and treatment is limited. Implementing telemental health services (TMHS) in Federally Qualified Health Centers (FQHCs) could improve accessibility to mental healthcare. This study assessed the effect of TMHS on mental health services utilization in FQHCs, comparing centers with and without TMHS and examined differences in TMHS effect between FQHCs that adopted TMHS before and during the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study utilized FQHC-level data from Uniform Data Systems annual performance reports (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20099540 FQHC-year) and county-level demographic, health status, and provider characteristic data from 2016 to 2022. A two-way fixed effects model was applied to examine the effect of TMHS on mental health visit rates, supplemented by the Sun and Abraham difference-in-differences estimator. The analysis included both pre-COVID and during-COVID TMHS adopters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FQHCs offering TMHS showed 1.04 times increase in overall mental health visit rates compared to those without TMHS. Centers serving higher proportions of Medicaid-insured (1.07 times) and low-income (below 200% FPL; 1.05 times) populations showed even higher visit rates. During-COVID TMHS adopters showed a significant increase (1.05 times), particularly in urban areas, whereas rural adopters did not see significant changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FQHCs offering TMHS showed increased mental health visit rates, especially among low-income and Medicaid-insured populations. FQHCs that adopted TMHS during the pandemic experienced a marked rise in mental health visits, but rural-urban disparities persist, highlighting the ongoing challenges in expanding access to mental healthcare in rural settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x241307417","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T03:30:59Z","timestamp":1737689459000},"page":"22-31","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of telemental health adoption on mental health services utilization in federally qualified health centers"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6900-2483","authenticated-orcid":false,"given":"Khyathi","family":"Gadag","sequence":"first","affiliation":[{"name":"University of Iowa College of Public Health"},{"name":"University of Iowa College of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanika","family":"Arora","sequence":"additional","affiliation":[{"name":"University of Iowa College of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney E","family":"Zahnd","sequence":"additional","affiliation":[{"name":"University of Iowa College of Public Health"},{"name":"University of Iowa College of Public Health"},{"name":"Rural Telehealth Research Center, The College of Public Health, The University of Iowa, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003 NSDUH Series H-56). Rockville MD: Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration 2021. https:\/\/www.samhsa.gov\/data\/."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7013e2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.15"},{"key":"e_1_3_2_5_2","first-page":"503","article-title":"The changing context of rural America: A call to examine the impact of social change on mental health and mental health care","volume":"68","author":"Carpenter-Song E","year":"2017","unstructured":"Carpenter-Song E, Snell-Rood C. The changing context of rural America: A call to examine the impact of social change on mental health and mental health care. 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New House Senate bills aim to make telehealth expansion permanent in Medicare Medicaid. FierceHealthcare https:\/\/www.fiercehealthcare.com\/payer\/new-house-senate-bills-aims-to-make-telehealth-expansion-permanent-medicare-medicaid (2021 accessed 11 December 2021)."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000776"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10740"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2023.0006"},{"key":"e_1_3_2_20_2","unstructured":"Archived Resources | Bureau of Primary Health Care https:\/\/bphc.hrsa.gov\/data-reporting\/uds-training-and-technical-assistance\/archived-resources (accessed 8 August 2023)."},{"key":"e_1_3_2_21_2","unstructured":"United States Census Bureau. SAIPE State and County Estimates for 2021. 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