New SAMHSA Telehealth Guide: Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders

Center for Connected Health Policy

June 2021

Telehealth implementation and outcome evaluation tools that will continue to assist treatment providers and organizations seeking to increase access to mental health services via telehealth

The Substance Abuse and Mental Health Services Administration (SAMHSA) and its National Mental Health and Substance Use Policy Laboratory recently released a new evidence-based resource guide titled, Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders, to support implementation of telehealth across diverse mental health and substance use disorder treatment settings. The guide examines the current telehealth landscape, including evidence on effectiveness and examples of programs that have integrated telehealth modalities (live-video, telephone, and web-based applications) for the treatment of serious mental illness (SMI) and substance use disorders (SUDs). Also included is guidance and resources for evaluating and implementing best practices which are presented across a continuum of services, such as screening and assessment, treatment, medication management, care management, recovery support, and crisis services.

The report speaks to how telehealth is known to improve access to care during emergencies and in rural and underserved areas, but stresses that implementation should be expanded outside of such situations and integrated into an organization’s standard practices to improve provider and patient communication, satisfaction, timeliness and continuity of care. The authors highlight how this is increasingly important when it comes to mental health issues, which impact millions of Americans that often face unique treatment gaps and barriers. Ultimately, it is suggested that with the right resources and upfront work, the evidence shows telehealth has the capability to address these barriers, improve health outcomes and care coordination, decrease costs and reduce health disparities.

Notable findings related to telehealth use and mental health include:
*Telehealth use doubled from 14% to 28% between 2016 and 2019
*Telehealth visits for mental health increased 556% between March 11 and April 22, 2020
*SUD treatment via telehealth increased from 13.5% to 17.4% between 2016 and 2019
*Telehealth use increased 425% for mental health appointments among rural Medicare
beneficiaries between 2010 and 2017

The guide presents specific strategies to increase patient access and comfort using telehealth, such as providing devices to those that need them and offering trial sessions to address any technological challenges. It is also suggested that providers first screen patients for their willingness and readiness to receive care via telehealth, as it may not be appropriate for some patients. Additionally, telephone should be encouraged when it reduces prior structural and institutional barriers that have made contacting underserved communities difficult. The guide also offers strategies to increase provider comfort using telehealth, such as:
*trainings and designating certain staff to support and evaluate its use
*how to create a similar environment to that of an in-person visit for patients
*addressing organizational infrastructure issues

Understanding and knowledge of relevant and ever-evolving regulatory and reimbursement policies is included as an important consideration as well, to which the authors offer a variety of tracking resources, including the policy finder tool on CCHP’s new website.

Regardless of where state and federal telehealth policies land, the guide includes a number of telehealth implementation and outcome evaluation tools that will continue to assist treatment providers and organizations seeking to increase access to mental health services via telehealth. Additional resources can be accessed on the SAMHSA website. For more information read the full SAMHSA resource guide- https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP21-06-02-001.pdf