Since March, the public health crisis caused by COVID-19 has changed many things about our day-to-day lives, including the way our patients access care and the way psychiatrists practice medicine. These changes have been driven by distancing guidelines meant to curtail the spread of the coronavirus and protect doctors, patients and their families.

To ensure that patients can continue to receive regular psychiatric care, federal and state governments have responded to the public health crisis by easing restrictions around telehealth related to live video sessions, audio-only psychotherapy, electronic prescribing, and more. These changes have eliminated barriers to care for patients, especially by lifting geographical restrictions and allowing patients to be seen in their home.

The use of telehealth was on the rise before COVID-19 and has become an essential tool for physicians everywhere as the global pandemic continues. APA is committed to ensuring that our members have the resources they need to adapt to these changes and meet the challenges of practicing medicine during the pandemic. We have catalogued the changes and made this information publicly available on our website along with our telehealth toolkit.

APA conducted a survey among its members to get a better understanding of how our member psychiatrists have adapted telehealth services into their practice in the era of COVID. Our members who responded practice in a variety of settings, including solo practice, hospitals, academic settings, group settings, and community mental health centers. Most accept some form of insurance, with about a quarter indicating that they were self-pay.

Respondents reported a big jump in the use of telehealth to see patients since the onset of the pandemic. Before, 62% reported seeing none of their patients via telehealth, while after the onset of the pandemic, 86% of respondents are now seeing nearly all of their patients via telehealth.

While not surprising given the circumstances, this trend does tell us that adopting telehealth into a practice can be done quickly, especially when numerous regulatory barriers are eliminated. 84% of psychiatrists who participated in the survey also said that their patients were either “somewhat satisfied” or “very satisfied,” with the transition to telepsychiatry.

One interesting bit of data revealed by the survey is that patient no-shows decreased substantially after psychiatrists switched to telepsychiatry. Before the switch, survey respondents indicated that only about 9% of their patients kept all their appointments. Now, that number has increased to about 33% of patients keeping all their appointments. This tells us that telehealth seems to be making it easier for our patients to not only access a psychiatrist, but also regularly keep their appointments. Being able to keep appointments is a strong indicator of eventual patient outcomes, so this dramatic decrease in no-shows is very positive news.

The ability to have audio-only (telephone) telehealth services covered for reimbursement at the same rate of regular telehealth is another possible reason for high patient satisfaction and the downward trend in no-shows. Respondents indicated using audio-only was important when bandwidth or video technology was unavailable. The Centers for Medicare and Medicaid services (CMS) and some private payers were not covering audio-only telehealth prior to the pandemic, but due in part to APA’s advocacy efforts they now are.

Moving forward, audio-only telehealth must continue to be covered, especially for the benefit of patients who lack access to live video technology or for those who live in areas without sufficient access to broadband internet.

It is paramount that our patients continue to have access to high-quality care via telehealth, both during and after the public health crisis subsides, and that psychiatrists can rely on being able to treat patients using telepsychiatry without encountering regulatory hurdles.

This survey tells us that psychiatrists can adapt telehealth quickly and successfully when the path forward is cleared of such hurdles. To that end, we are making every effort to ensure that our member psychiatrists are ready to integrate telehealth into their practice. APA has scheduled a webinar on Advancing the Use of Telehealth Through Education and Advocacy for Wednesday, July 8 at 7:00 p.m. E.T. This webinar will focus on how to refine the use of telehealth to better serve patients, how to bill for these services, and highlight advocacy efforts at the federal and state levels to continue telehealth flexibilities.

The APA will continue these advocacy efforts so that the positive policy changes made to expand telehealth services are retained after the public health crisis from COVID-19 subsides.

As we move into the July 4th long weekend, I urge all of us to wear masks, wash hands frequently or use hand sanitizers, maintain six feet of separation and ensure that if you do go out to eat the safest place to eat is sitting outside.