From remote schooling and socializing to news gathering and entertainment, today’s young people spend much of their time online—and The Jed Foundation (JED) believes that their virtual options should include quality, effective health care. Telehealth allows health care providers to expand access, but it also brings a unique set of limitations and considerations. Therefore, JED urges policymakers, researchers, and stakeholders to evaluate telehealth effectiveness in mental health care, especially for teens and young adults.
During the COVID-19 pandemic, telehealth services helped people receive timely information and meet with health care providers remotely, allowing them to circumvent any risk of exposure that in-person appointments might entail. This option was embraced by young people: In 2020, around 33% of those ages 14 to 24 had participated in a telehealth visit—a significant jump from around just 10% in 2019.
Telehealth visits provided mental health care support and treatment at a pivotal time. During the pandemic, around 30% of young adults ages 18 to 25 reported feeling symptoms of anxiety and depression. As of 2021, nearly 70% of young people between ages 12 and 17 believed that the pandemic negatively affected their mental health.
Research shows that between March and August of 2020, at the height of the first wave of COVID-19, 40% of mental health and substance use outpatient visits were conducted via telehealth. Children and teens benefitted from expanded telemental health access: People under age 18 accounted for one third of all virtual mental health visits.
Increased access to telehealth services was brought about in large part by changes in regulations around telehealth service delivery, such as:
- Removing restrictions: Private insurance companies and Medicaid removed pre-pandemic restrictions on coverage and reimbursement for telemental health services, expanding access to care.
- Improving access: Multiple states allowed temporary licenses to providers licensed in other states to increase access to care via telehealth. Relaxed licensure requirements have helped young people maintain continuity of care with trusted providers if they chose to leave their home state for school or work.
Changing regulations have proven beneficial for accessing mental health services, particularly for groups that struggled to access care pre-pandemic, such as rural communities, people without reliable transportation, or people with physical limitations. Because telehealth allows for greater flexibility in scheduling, it also removes barriers for people with busy schedules (such as students or parents/caretakers, among others).
Studies show that telehealth has been beneficial to Black patients accessing and completing appointments, which helps close the racial gaps that exist in traditional healthcare settings. Still, more research is needed to see how other factors—such as geography, reliable internet access, and socioeconomic status—intersect with data about telehealth usage by race.
In addition to helping individuals, telehealth options can help institutions with limited capacity provide better mental health services for young people. For example, while half of all people with mental health disorders begin showing symptoms in childhood, many school systems are not equipped with enough staff or the correct training to assist every student who is struggling. During the pandemic, many school systems adopted telehealth programs to support students. Continuing these programs could greatly expand the schools’ capacity to address signs of mental health issues early. But to continue successfully, these programs must be designed effectively, funded sustainably, and supported by state health policies that promote flexibility and equity.
While telehealth offers significant benefits, it also presents new challenges, particularly for those who lack reliable internet access or digital literacy skills. For teens and young adults living with family, there are some concerns around maintaining privacy for telehealth visits; for example, LGBTQ inidividuals who do not feel accepted at home, or those living with physically or emotionally abusive relatives, might not feel like they are able to openly discuss these issues in a shared living space.
Additionally, while young people have increasingly taken advantage of telehealth options, many still want the option of in-person visits: In one survey, nearly half of young people responded that telehealth visits were not as effective as in-person visits, citing examples such as having difficulty performing physical exams or—importantly for mental health visits—reading body language cues. It is important to conduct more research on the effectiveness of telehealth so that providers may consider how telehealth can be better integrated into treatment plans and supplement in-person care.
As in-person appointments resume, telehealth remains a strong alternative. But the telehealth protections that were put in place following the declared pandemic public health emergency may go away once the declaration ends. If telehealth regulations are changed back to what they were pre-pandemic, many young people may lose critical access to mental health services.
As the pandemic evolves and mental health concerns among young people continue to rise, the need remains for expanded access to preventive measures and treatment options. JED believes that telehealth technology can be a powerful tool for addressing the growing demand for mental health services among teens and young adults, and more investment is needed to ensure continued access to effective and affordable virtual mental health care.