Telehealth

Where We Stand

NAMI believes that public policies and practices should promote access to care for people with mental health conditions. NAMI supports laws and policies that expand the use of telehealth practices to support a wide range of effective and accessible mental health care services.

Why We Care

Despite a growing demand for mental health services, many people across the U.S. are still unable to receive the help they need. Over half of U.S. counties have no psychiatrists, and even in areas that have mental health providers, there are often not enough to meet the need — especially if patients must travel long distances to reach available providers.

Telehealth is a growing, effective way to provide mental health care when patients and providers are in different physical locations. It supports long-distance clinical health care using two-way telecommunications technologies like computers, tablets, or cell phones. This can improve access to mental health care and can give patients and providers more flexibility. Telehealth can eliminate the barrier of needing transportation and decrease “no-shows,” resulting in greater continuity of treatment. For some populations like children and adolescents, it may also create a better experience than traditional therapy sessions. Additionally, telehealth can increase access to culturally competent and clinically specific clinicians, for underserved individuals.

Interest and use of telehealth have expanded in recent years, yet some forms of health care insurance have limited coverage for telehealth services. These restrictions rapidly changed during the COVID-19 global pandemic to help limit risk of exposure during in-person visits. The federal government significantly expanded access to telehealth, including telemental health, for individuals covered by Medicare at the beginning of the pandemic through the end of the public health emergency declaration. Likewise, states were provided additional flexibilities to expand telehealth coverage and reimbursement for their Medicaid programs. These temporary flexibilities have highlighted the promise of telehealth in supporting timely and safe access to mental health care services.

Telehealth has been shown to improve patient satisfaction and be cost effective for many diagnoses and has become an essential tool to help improve mental health care access. NAMI believes policymakers should strengthen and expand telehealth coverage for mental health across all settings and forms of health coverage, including allowing reimbursement for new patients using telehealth. At the same time, providers and insurers should be encouraged to promote patient privacy protocols when patients use telehealth services. Additionally, further research should be prioritized to better understand different modes of treatment that best serve individual needs.

How We Talk About It

• Across the U.S., many people are unable to receive the mental health care they need, facing barriers like mental health provider shortages in their area.
• For many people, telehealth can be an easy and effective way to receive mental health care on their computers, tablets or cell phones.
• Telehealth is also an important tool to improve access to care for marginalized and underserved communities.
• People with disabilities, areas with mental health provider shortages, and rural communities can all benefit from telehealth options when regular travel to in-person appointments can be difficult.
• Expanded access to telehealth services has been especially important to help people with mental health conditions continue to get mental health care during the COVID-19 pandemic.
• While some people may need more intensive, in-person services, it is important that telehealth be permanently available to provide people with mental health conditions with a range of options for care — especially those who have gained access to mental health treatment for the first time only through telehealth.
• NAMI supports laws and policies that expand the use of evidence-based telehealth practices to allow people with a mental health condition to have access to a wide range of mental health care services and options for care.

What We’ve Done

• NAMI letter with the Mental Health Liaison Group to HHS Administrator Verma requesting emergency regulations providing flexibility for telehealth in federally funded health programs be extended following the emergency period.
• NAMI letter with the Partnership to Protect Care to Congressional and HHS leadership, providing the patient perspective and telehealth principles used evaluate legislative or regulatory efforts on telehealth.
• NAMI report, State Legislation Report: Trends in State Mental Health Policy (2019), which includes examples of legislation addressing use of telehealth for mental health services.
• NAMI press release on the U.S. House of Representatives’ passage of The Commander John Scott Hannon Veterans Mental Health Care Improvement Act, which included a VA telehealth component to help rural veterans.
• NAMI letter with the Partnership to Protect Care to Congressional leadership, providing the patient perspective and telehealth principles used evaluate legislative or regulatory efforts on telehealth.