Disparities still rife in state telemental health policies


There are eight states in the U.S. that have a policy landscape that supports the use of telemedicine for mental and behavioral health. At the same time, there are 41 states that have much room for improvement in this area, according to a recent report from the American Telemedicine Association.

The report is the third of its kind by the ATA examining the “complex telehealth policy landscape for licensed psychologists across the country.”

The analysis mirrors closely that of telemedicine for all medical practice: There are positive outcomes from telemedicine use and increased use of the technology, but licensing boards have a fragmented approach state-to-state that negatively impacts accessibility and availability of the services.

The ATA gave states a grade, A through F, to rate their psychology board practice standards. Only one, Colorado, receive an F, which suggests many barriers for telemental health advancement. To calculate the grade, the researchers weighed three factors: Psychologist-patient encounter, informed consent and licensure and out-of-state practice.

Some findings include:

  • Forty-four states were ranked high for psychologist-patient encounters, though Arkansas and Colorado rank the lowest with failing scores, “mainly because of policies recommending initial in-person encounters,” according to the report.
  • A good chunk of states don’t ask for patient informed consent before a telemedicine visit; eight states do--Arizona, California, Colorado, Connecticut, Delaware, Idaho, Kentucky, Louisiana, and New York--as does the District of Columbia.
  • Texas was the only state that received an A for licensure policies. In addition, there are 31 states that expedite the licensure process, but the report states that practitioners still need “a full and unrestricted license in order to practice within state.”
  • As for practicing across state lines, the researchers said that whether telemedicine is used, it’s still an arduous process thanks to restrictive policies. Not a single state received an A for the category, and there were eight states that received an F.

A survey of providers by law firm Epstein Becker Green in May also found that while telemental health helps to bridge the gaps that exist in providing mental health services to patients, there are many barriers to providing such services.

To learn more:
- here's the ATA's report (.pdf)