TY  - JOUR
PY  - 2023//
TI  - The rapid shift to virtual mental health care: examining psychotherapy disruption by rurality status
JO  - Journal of rural health
A1  - Miller-Matero, Lisa R.
A1  - Knowlton, Gregory
A1  - Vagnini, Kaitlyn M.
A1  - Yeh, Hsueh-Han
A1  - Rossom, Rebecca C.
A1  - Penfold, Robert B.
A1  - Simon, Gregory E.
A1  - Akinyemi, Esther
A1  - Abdole, Lana
A1  - Hooker, Stephanie A.
A1  - Owen-Smith, Ashli A.
A1  - Ahmedani, Brian K.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Given the low usage of virtual health care prior to the COVID-19 pandemic, it was unclear whether those living in rural locations would benefit from increased availability of virtual mental health care. The rapid transition to virtual services during the COVID-19 pandemic allowed for a unique opportunity to examine how the transition to virtual mental health care impacted psychotherapy disruption (i.e., 45+ days between appointments) among individuals living in rural locations compared with those living in nonrural locations. <br><br>METHODS: Electronic health record and insurance claims data were collected from three health care systems in the United States including rurality status and psychotherapy disruption. Psychotherapy disruption was measured before and after the COVID-19 pandemic onset. <br><br>RESULTS: Both the nonrural and rural cohorts had significant decreases in the rates of psychotherapy disruption from pre- to post-COVID-19 onset (32.5-16.0% and 44.7-24.8%, respectively, p < 0.001). The nonrural cohort had a greater reduction of in-person visits compared with the rural cohort (96.6-45.0 vs. 98.0-66.2%, respectively, p < 0.001). Among the rural cohort, those who were younger and those with lower education had greater reductions in psychotherapy disruption rates from pre- to post-COVID-19 onset. Several mental health disorders were associated with experiencing psychotherapy disruption. <br><br>CONCLUSIONS: Though the rapid transition to virtual mental health care decreased the rate of psychotherapy disruption for those living in rural locations, the reduction was less compared with nonrural locations. Other strategies are needed to improve psychotherapy disruption, especially among rural locations (i.e., telephone visits).<p />  <p>Language: en</p>
LA  - en
SN  - 0890-765X
UR  - http://dx.doi.org/10.1111/jrh.12818
ID  - ref1
ER  -