Implementation of Telehealth among Behavioral Health Providers Serving Rural and Hard to Reach Populations

Background: Telehealth is defined as the use of electronic information and telecommunications technologies to support long-distance clinical healthcare, health education, and health administration.  Although telehealth services do not directly address overall shortages of behavioral health clinicians, telehealth can improve access to health services in rural areas by providing a way for clinicians to deliver care to rural consumers in relatively distant locations. Methods:  In 2011, SAMHSA’s Center for Substance Abuse Treatment launched its Targeted Capacity Expansion-Technology Assisted Care Program.  The purpose of this program was to leverage technology to enhance and/or expand the capacity of substance abuse treatment providers to serve persons in treatment who have been underserved because of lack of access to treatment.  In cohort 1, seven grantees representing the southeastern, southwestern, central, and western regions (Regions IV, V, IX) implemented telehealth through videoconferencing technologies.  Results:  Upon intake, 1,343 participants were engaged in a telehealth intervention and nearly 50% were retained during the 6-month follow up.  Among those retained, on average there was a 50% increase in employment/education, 25% increase in stable housing, and a significant increase in drug/alcohol use abstinence.   In addition, there was a 30% decrease in depressive symptoms as well as a significant decrease in attempted suicide in previous 30 days, injection of illegal drugs, unprotected sex with an ID user, and unprotected sex with a high individual.  Conclusion: Given the lack of substance abuse treatment providers nationally, telehealth can be an effective tool to provide treatment to individuals who are unable to access care.