(PS10-B30) An Examination of the Impact of the COVID-19 Pandemic and the Transition to Telehealth on Mental Health Treatment

In this retrospective study, the effect of the transition to teletherapy, precipitated by the COVID-19 pandemic, on patient treatment adherence and depression severity was evaluated in an urban epicenter of the early pandemic. Health and mental health were especially compromised due to poverty, high rates of unemployment, and a population largely comprised of families from minoritized backgrounds who experience disproportionately high barriers to care. The use of telehealth during the Coronavirus pandemic has lowered barriers to mental health care through increased flexibility and decreased costs by eliminating factors associated with travel. However, telehealth may negatively affect the perceived quality of the clinician and patient relationship due to technological issues interfering with treatment, lack of patient knowledge or access to devices, and room for various distractions. Data from 3,921 patients at psychiatric clinics that are a part of the Montefiore-Einstein system in the Bronx, NY were assessed. Paired t-tests were used to compare the number of missed appointments and PHQ-9 scores between pre- versus during-pandemic time periods to assess whether the switch to telehealth services was significantly associated with treatment adherence and/or depression severity. Linear mixed models were used to compare the number of missed appointments and PHQ-9 scores between the pre- versus during-pandemic time periods unadjusted and adjusted for covariates including age, sex, race/ethnicity, and insurance status as a proxy for socioeconomic status. The transition from in-person to virtual therapy was found to be associated with significantly reduced numbers of missed visits (mean change = 2.80, SD = 4.92, p < .0001) and significantly reduced depressive symptoms according to the PHQ-9 in the overall sample (mean change = 1.36, SD = 3.91, p < .0001). The results indicated that telehealth increased opportunities to access care and may therefore improve mental wellbeing. Telehealth is an effective modality for treatment delivery, especially for families facing substantial barriers to mental health services. The rising use and research of teletherapy should continue, as the initial switch to telehealth significantly improved patient treatment adherence and depression severity in the present study. Although a significant correlation between the transition to teletherapy, increased treatment adherence, and reduced symptom severity was established, the results did not demonstrate causality. Future research should explore whether there is a causal relationship between these variables and examine hybrid models of virtual/in-person therapy to determine ideal modalities for distinct psychiatric conditions and patient populations.