Sustained Utilization of Video-Based Outpatient Psychiatry Visits Following the COVID-19 Public Health Emergency at an Academic Health Center.

Abstract

Background: Telepsychiatry expanded rapidly during the COVID-19 pandemic to support continuity of psychiatric care, although its long-term durability following the expiration of pandemic-era policies remains uncertain. This study evaluated long-term utilization of telepsychiatry and patient and clinician acceptability within outpatient practice.

Methods: A repeated cross-sectional electronic health record analysis of outpatient psychiatric visits from 2020 to 2025 compared in-person and virtual visit completion and no-show rates across five annual intervals. Telepsychiatry acceptability was evaluated through a patient survey administered in 2021-2022 (n = 655) and clinician surveys conducted in 2020 (n = 50) and 2025 (n = 38).

Results: Among 219,007 visits, 44% were in-person and 56% were virtual. The overall no-show rate was 10.46%, with no significant difference between visit types (p = 0.178). Two intervals demonstrated significant differences: 2021-2022 (virtual = 9.6%, in-person = 11.0%, p < 0.001) and 2024-2025 (virtual = 11.9%, in-person = 10.9%, p < 0.001). The percentage of no-show visits increased as virtual visits decreased (Spearman's correlation = -0.90, p = 0.037). Most patients agreed that their telepsychiatry visit was as good as in-person (92.4%) and more convenient (97.1%). Provider belief that virtual visits were as effective as in-person decreased from 92.0% in 2020 to 74.3% in 2025 (p = 0.026).

Conclusions: Telepsychiatry utilization remains a substantial component of outpatient care. Comparable no-show rates and high patient satisfaction support telepsychiatry as a viable and acceptable modality, although provider enthusiasm appears to have moderated over time.