Study Reveals Persistent Telehealth Disparities in Depression Management: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in PNAS Nexus that was designed to assess changes in mental health care utilization from 2016 to 2024 among people with depression.

The study

Researchers used 8 years of patient data from the electronic health records of patients with depression at a large, academic, urban health system. They examined data from 132 275 mental health visits by 29 08 patients receiving primary care treatment for depression and 172 080 visits by 7577 patients treated in psychiatry from July 2020 to June 2024. Research questions included how trends in mental health care utilization changed from 2016 to 2024 across levels of area deprivation index (ADI) percentiles and how trends in telehealth use for mental health care differed from 2020 to 2024 across levels of ADI.

The findings

Between July 2016 and June 2019, results showed that the volume of mental health care delivered to patients from low-deprivation areas (1st–25th national ADI percentile) was increasing at a steeper rate than for high-deprivation areas (76th–100th national ADI percentile). Also, from mid-2021 through mid-2024, patients from high-wealth neighborhoods were significantly more likely to use telehealth compared to those from low-wealth neighborhoods. The odds of telehealth use were 1.62 times higher for primary care mental health visits and 1.67 times higher for psychiatry visits among high-wealth patients.

Authors' comments

"It is unknown how changes in mental health care utilization from prepandemic to postpandemic varied for patients across deprivation areas and whether differences in the use of telehealth could contribute to disparities in utilization. We found that after rapid changes in utilization at the start of the pandemic, volume of mental health care delivered to patients from high-deprivation areas dropped off more steeply than for patients from low-deprivation areas. Patients in lower deprivation areas were also more likely than patients in more deprived areas to use telehealth than in-person care. Action is needed to ensure that differences in use of telehealth across socioeconomic groups do not contribute to differences in care."

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