background: Nearly one-fifth (19.5%; 95% CI: 18.5-20.5) of Indiana adults will experience a depressive disorder at some point in their life. Most of rural Indiana is classified as a mental health professional shortage, placing patients at a severe disadvantage when seeking treatment for mental health disorders. The Indiana Rural Health Association (IRHA) has partnered with Union Hospital’s Richard G. Lugar Center for Rural Health and multiple rural hospitals to build the Crossroads Partnership for Telehealth (Crossroads) funded through the Health Resources and Services Administration.

objective: This project’s goals are to develop and maintain a telehealth network that will increase access to behavioral health care services in rural communities and conduct evaluations of patient utilization. This is an effort to both expand and strengthen the evidence-base for assessing the effectiveness of tele-behavioral health care services for patients, providers, and payers.

methods: Crossroads will combat access to care concerns by advancing the accessibility and capability of tele-behavioral health care by recruiting hospitals, in geographically and culturally disparate, rural counties across the state of Indiana. This will allow behavioral health providers to conduct virtual appointments with patients who visit an emergency department or primary care clinic. Crossroads will then measure the effectiveness of these appointments by administering evidence-based instruments, including the PROMIS and PHQ-9 to analyze patient outcomes.

results: Since Crossroads implementation in late 2018, five health systems have partnered with the IRHA. Thus far, 78 encounters have utilized the network technology. Roughly, 66% of the visits have been for substance use treatment and 33% for general behavioral health, including depression and anxiety.

conclusion: Crossroads will provide individuals with resources to tele-behavioral health clinicians in areas that otherwise would not have the capability of treating. This, in return, has created an innovative network, that will provide quantitative and qualitative data that will inform future successes of tele-behavioral health initiatives statewide and nationwide.