Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: A Systematic Review.

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  • Additional Information
    • Source:
      Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100959949 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3669 (Electronic) Linking ISSN: 15305627 NLM ISO Abbreviation: Telemed J E Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c2000-
    • Subject Terms:
      COVID-19*/epidemiology ; Telemedicine*/statistics & numerical data ; Substance-Related Disorders*/therapy ; Substance-Related Disorders*/epidemiology ; Health Equity* ; Mental Disorders*/therapy ; Mental Disorders*/epidemiology; Humans ; SARS-CoV-2 ; Pandemics ; Mental Health ; Healthcare Disparities/statistics & numerical data
    • Abstract:
      Background: As a result of the COVID-19 public health emergency (PHE), telehealth utilization accelerated to facilitate health care management and minimize risk. However, those with mental health conditions and substance use disorders (SUD)-who represent a vulnerable population, and members of underrepresented minorities (e.g., rural, racial/ethnic minorities, the elderly)-may not benefit from telehealth equally. Objective: To evaluate health equality in clinical effectiveness and utilization measures associated with telehealth for clinical management of mental health disorders and SUD to identify emerging patterns for underrepresented groups stratified by race/ethnicity, gender, age, rural status, insurance, sexual minorities, and social vulnerability. Methods: We performed a systematic review in PubMed, Embase, Cochrane Central Register of Controlled Trials, and CINAHL through November 2022. Studies included those with telehealth, COVID-19, health equity, and mental health or SUD treatment/care concepts. Our outcomes included general clinical measures, mental health or SUD clinical measures, and operational measures. Results: Of the 2,740 studies screened, 25 met eligibility criteria. The majority of studies ( n  = 20) evaluated telehealth for mental health conditions, while the remaining five studies evaluated telehealth for opioid use disorder/dependence. The most common study outcomes were utilization measures ( n  = 19) or demographic predictors of telehealth utilization ( n  = 3). Groups that consistently demonstrated less telehealth utilization during the PHE included rural residents, older populations, and Black/African American minorities. Conclusions: We observed evidence of inequities in telehealth utilization among several underrepresented groups. Future efforts should focus on measuring the contribution of utilization disparities on outcomes and strategies to mitigate disparities in implementation.
    • Contributed Indexing:
      Keywords: COVID-19; health inequities; mental health; opiate substitution treatment; rural population; substance-related disorders; systematic review; telehealth; telemedicine; vulnerable populations
    • Publication Date:
      Date Created: 20240116 Date Completed: 20240502 Latest Revision: 20240625
    • Publication Date:
      20240625
    • Accession Number:
      10.1089/tmj.2023.0588
    • Accession Number:
      38227387