Transitioning to telemental health: Sociodemographic predictors of integrated behavioral health care utilization pre- and peri-COVID.

Abstract

Introduction: The transition to telehealth as a result of the COVID-19 pandemic brought the potential to ameliorate or exacerbate disparities in access to behavioral health care. This study examined patient-specific sociodemographic predictors of integrated behavioral health (IBH) utilization prior to and during COVID to identify variations in care access.

Method: Data from three primary care clinics across two medical centers (N = 819 patients), and multivariate general linear modeling, were used to test direct associations between age, sex, primary language, and race/ethnicity and use of IBH services pre-COVID (March 2019-February 2020) versus peri-COVID (March 2020-February 2021). Moderated effects due to health care system-specific telehealth modalities were also tested.

Results: Findings suggest patients completing peri-COVID IBH visits were significantly younger than pre-COVID, specifically among patients seen in academic medical center settings with primarily video-based IBH care. Results also indicate patients engaging in peri-COVID IBH were significantly more likely to identify as Hispanic/Latino than non-Hispanic White, specifically among county-funded clinic patients receiving phone-based IBH.

Discussion: The transition to telehealth-delivered IBH care may have reduced behavioral health care access for aging patients, who are least likely to be comfortable with video-based care. The use of phone visits may have improved access for underserved Hispanic/Latino patients, who may experience barriers to in-person care. Aligning telemental health care with primary care patients' preferences and access to telehealth-ready devices may amplify IBH-related improvements to mental health care access. (PsycInfo Database Record (c) 2025 APA, all rights reserved).