Telemental Health Uptake in an Outpatient Clinic for Veterans During the COVID-19 Pandemic and Assessment of Patient and Provider Attitudes

Public Significance Statement Rapid and wide-spread uptake of telemental health in an outpatient clinic serving veterans and military service members was feasible and deemed satisfactory to patients and providers. Telemental health was associated with lower no-show rates. This study aimed to (a) describe the process of rapid uptake of telemental health in an outpatient mental health clinic for veterans and their family members during the coronavirus disease 2019 (COVID-19) pandemic and (b) present patient and provider attitudes about telemental health. Virtual visit (video and phone) trends for this clinic are described over the 8 weeks pre- and post-COVID-19 closure. As part of a quality improvement initiative over a subsequent 2-week period, 147 patient visits (127 unique individuals), and 24 mental health providers who were part of a multidisciplinary team were eligible to complete an anonymous self-report satisfaction survey immediately after a telehealth session. Prior to the COVID-19 closure, the clinic averaged 112.75 completed visits per week, with virtual visits accounting for less than 5% of all appointments. In the second month after closure, the clinic averaged 153.75 completed visits per week (36.36% increase in volume), with virtual visits accounting for 100% of visits (42% phone, 58% video). The proportion of video compared to telephone visits increased pre to postclosure. The no-show rate significantly decreased pre to postclosure (10.87% vs. 15.01%, resp., chi(2) = 17.81, p < .001). Patient and provider satisfaction with telemental health were high. Prospectively, most patients (83.56%) expressed preference for televisits-only or televisits combined with in-person visits. Patients and providers were satisfied with telemental health. Convenience was an oft-cited advantage by both patients and providers. Telemental health may represent a cost-effective solution to mental health care access during and beyond COVID-19.