The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
COVID-19 and telepsychiatry: Early outpatient experiences and implications for the future
Open accessAbstract
The COVID-19 pandemic has dramatically transformed the U.S. healthcare landscape. Within psychiatry, a sudden relaxing of insurance and regulatory barriers during the month of March 2020 enabled clinicians practicing in a wide range of settings to quickly adopt virtual care in order to provide critical ongoing mental health supports to both existing and new patients struggling with the pandemic's impact. In this article, we briefly review the extensive literature supporting the effectiveness of telepsychiatry relative to in-person mental health care, and describe how payment and regulatory challenges were the primary barriers preventing more widespread adoption of this treatment modality prior to COVID-19. We then review key changes that were implemented at the federal, state, professional, and insurance levels over a one-month period that helped usher in an unprecedented transformation in psychiatric care delivery, from mostly in-person to mostly virtual. Early quality improvement data regarding virtual visit volumes and clinical insights from our outpatient psychiatry department located within a large, urban, tertiary care academic medical center reflect both the opportunities and challenges of virtual care for patients and providers. Notable benefits have included robust clinical volumes despite social distancing mandates, reduced logistical barrieres to care for many patients, and decreased no-show rates. Finally, we provide clinical suggestions for optimizing telepsychiatry based on our experience, make a call for advocacy to continue the reduced insurance and regulatory restrictions affecting telepsychiatry even once this public health crisis has passed, and pose research questions that can help guide optimal utilization of telepsychiatry as mainstay or adjunct of outpatient psychiatric treatment now and in the future.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The COVID-19 pandemic imposed the sudden conversion of in-person to telehealth visits in healthcare systems throughout the world (Chen et al., 2020; Torales et al., 2022).”
From Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study (2022) · cites this paper as Chen et al., 2020
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.3976 · Cited by 8,015 · cited 1×
“Additionally, healthcare providers working in demanding, high-risk situations are susceptible to a wide range of mental health conditions, including Acute Stress Disorder and Posttraumatic Stress Disorder [22].”
Ho, C. S., Chee, C. Y., & Ho, R. C. (2020) · Annals of the Academy of Medicine, Singapore · doi:10.47102/annals-acadmedsg.202043 · Cited by 1,699 · cited 1×
“However, psychiatric services remained important for managing pandemicassociated exacerbations in pre-existing psychiatric conditions [20], as well as to address new-onset psychological distress related to increased social isolation, financial and employment instability [21], significant anxiety and uncertainty, and g…”
Ho, C. S. H., Chee, C. Y., & Ho, R. (2020) · PubMed · Cited by 1,354
Dorsey, E. R., & Topol, E. J. (2016) · New England Journal of Medicine · doi:10.1056/nejmra1601705 · Cited by 1,211 · cited 2×
“Already-vulnerable patients such as the poor, the elderly, and those located in rural areas will face further health service disparities due to the “digital divide” [37].”
The Role of Telehealth in Reducing the Mental Health Burden from COVID-19
Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020) · Telemedicine and e-Health · doi:10.1089/tmj.2020.0068 · Cited by 1,159 · cited 1×
“However, psychiatric services remained important for managing pandemicassociated exacerbations in pre-existing psychiatric conditions [20], as well as to address new-onset psychological distress related to increased social isolation, financial and employment instability [21], significant anxiety and uncertainty, and g…”
Covid-19 and Health Care’s Digital Revolution
Keesara, S., Jonas, A., & Schulman, K. (2020) · New England Journal of Medicine · doi:10.1056/nejmp2005835 · Cited by 1,126 · cited 1×
“The most commonly cited barriers included poor reimbursement and regulatory hassles [7],”
The Effectiveness of Telemental Health: A 2013 Review
Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013) · Telemedicine and e-Health · doi:10.1089/tmj.2013.0075 · Cited by 1,048 · cited 1×
“” [1] Although telehealth has consistently demonstrated positive benefits in diverse clinical settings [2] and patient populations [3], and is generally viewed positively by patients and providers [4,5], it was not uniformly adopted prior to COVID-19.”
Review of key telepsychiatry outcomes
Hubley, S., Lynch, S. B., Schneck, C., Thomas, M., & Shore, J. (2016) · World Journal of Psychiatry · doi:10.5498/wjp.v6.i2.269 · Cited by 492 · cited 4×
“More frequent disruptions, difficulty reading nonverbal communications, and increased effort required to establish rapport have all been previously reported [5,8] and are anecdotally confirmed by our clinicians.”
InfluentialUsefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches
Chakrabarti, S. (2015) · World Journal of Psychiatry · doi:10.5498/wjp.v5.i3.286 · Cited by 292 · cited 4×
“With advances in technology, adoption of telepsychiatry slowly increased in the ensuing decades [8].”
InfluentialHong, Y.-R., Lawrence, J., Williams Jr, D., & Mainous III, A. (2020) · JMIR Public Health and Surveillance · doi:10.2196/18961 · Cited by 236
Cited by
Sorted by citations
Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022) · JMIR Mental Health · doi:10.2196/35159 · Cited by 436
Appleton, R., Williams, J., Juan, N. V. S., Needle, J. J., Schlief, M., Jordan, H., Rains, L. S., Goulding, L., Badhan, M., Roxburgh, E., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/31746 · Cited by 219
“[7,50,52,54,56,58,61,75,79,81,82,113,114] Adoption • Remote working was generally well adopted (most service users switched to remote working).”
BackgroundInfluentialThomas, N., McDonald, C., de Boer, K., Brand, R. M., Nedeljkovic, M., & Seabrook, L. (2021) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12332 · Cited by 132
Shim, R. S., & Starks, S. M. (2021) · Psychiatric Services · doi:10.1176/appi.ps.202000725 · Cited by 106
Digital Clinics and Mobile Technology Implementation for Mental Health Care
Connolly, S. L., Kuhn, E. R., Possemato, K., & Torous, J. B. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-021-01254-8 · Cited by 106
Metadata
- Authors
- Chen, J. A., Chung, W.-J., Young, S. K., Tuttle, M. C., Collins, M. B., Darghouth, S. L., Longley, R., Levy, R., Razafsha, M., Kerner, J. C., Wozniak, J., & Huffman, J. C.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Chen, Justin A.
- ORCID
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 66
- Pages
- 89-95
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC7347331
- OpenAlex
- W3040928965
- Cited by
- 227
- References
- 28
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 24 · 2023: 40 · 2022: 52 · 2021: 85 · 2020: 8
- FWCI
- 7.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Patient-Centered Outcomes Research Institute
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Keywords
- telepsychiatry, COVID-19 pandemic, virtual care, outpatient psychiatric care, mental health service delivery, insurance coverage barriers, regulatory challenges, no-show rates, quality improvement, social distancing
- MeSH terms
- COVID-19, Ambulatory Care, Mental Disorders, Humans, Mental Health Services, Pneumonia, Viral, Psychiatry, Telemedicine, Coronavirus Infections, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
