A new study led by Johns Hopkins Bloomberg School of Public Health highlights the socioeconomic divide in telehealth usage for mental health care, particularly among patients suffering from depression.
A disparity in mental health care access has come to light in a recent study led by researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in the journal PNAS Nexus, found that patients with depression from high-wealth neighborhoods in Maryland were significantly more likely to utilize telehealth services compared to their counterparts in low-wealth neighborhoods from mid-2021 through mid-2024.
The research team analyzed electronic health records from the Johns Hopkins Health System, spanning from mid-2016 to mid-2024, to understand the evolution of telehealth use during and after the COVID-19 pandemic. They used the Area Deprivation Index (ADI) to categorize neighborhoods based on socioeconomic status, considering factors like income, education, employment and housing quality.
The study revealed a stark contrast in telehealth adoption. During the pandemic, telehealth became a lifeline for many, especially when in-person visits were not feasible. However, the benefits were not evenly distributed.
From mid-2021 to mid-2024, patients from high-wealth neighborhoods were 1.62 times more likely to have telehealth visits in primary care and 1.67 times more likely in psychiatry compared to those from low-wealth areas.
“Telehealth for mental health may reduce barriers to accessing care for some, but our findings suggest that telehealth may not be improving access to care for all patients, especially those living in low-wealth/high-deprivation areas,” lead author Catherine Ettman, an assistant professor in the Bloomberg School’s Department of Health Policy and Management, said in a news release.
The data also indicated a rise in overall mental health care visits in psychiatry from mid-2016 to mid-2019, particularly among patients from wealthier areas. Post-pandemic, while the rate of telehealth visits dropped for all groups, patients from wealthier neighborhoods maintained elevated levels of telehealth use, whereas those from poorer areas reverted to pre-pandemic levels.
The digital divide presents a significant barrier to telehealth utilization. Video telehealth, in particular, demands a personal computer, high-speed internet, privacy and technical know-how — resources more readily available to wealthier individuals. This digital gap may contribute to the unequal health care accessibility observed in the study.
“It is important to consider how telehealth may improve access to care and what we can learn from the groups it has helped most so that we can adjust and support patients who may need more mental health care services,” Ettman added.
The study brings to light critical considerations for policymakers and health care providers looking to bridge the gap in mental health service delivery. As telehealth continues to evolve, ensuring equitable access remains paramount.