Determinants of Telehealth Service Use among Mental Health Patients: A Case of Rural Louisiana

Int J Environ Res Public Health. 2022 Jun 6;19(11):6930. doi: 10.3390/ijerph19116930.


The COVID-19 pandemic decreased the in-person outpatient visits and accelerated the use of telehealth services among mental health patients. Our study investigated the sociodemographic and clinical correlates of the intensity of telehealth use among mental health patients residing in rural Louisiana, United States. The study sample included 7069 telehealth visits by 1115 unique patients encountered from 1 April 2020 to 31 March 2021 at six mental health outpatient clinics managed by the Northeast Delta Human Services Authority (NEDHSA). We performed a negative binomial regression analysis with the intensity of service use as the outcome variable. Being younger, female, and more educated were associated with a higher number of telehealth visits. The prevalence of other chronic conditions increased telehealth visits by 10%. The telehealth service intensity varied across the nature of mental health diagnoses, with patients diagnosed with the schizophrenia spectrum and other psychotic disorders utilizing 15% fewer telehealth visits than patients diagnosed with depressive disorders. The promotion of telehealth services among mental health patients in the rural setting might require the elimination of the digital divide with a particular focus on the elderly, less educated, and those with serious mental health illnesses such as schizophrenia and psychotic disorders.

Keywords: COVID-19; mental health; rural; telehealth; visit intensity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19* / epidemiology
  • Female
  • Humans
  • Mental Health
  • Pandemics
  • Rural Population
  • Telemedicine*
  • United States

Grant support

Article processing charge (APC) was supported by the Northeast Delta Human Services Authority (NEDHSA). K.P.P.’s time in this paper was supported by the intramural research program of the U.S. Department of Agriculture, Economic Research Service. The findings and conclusions in this presentation are those of the authors and should not be construed to represent any official USDA, U.S. Government, or LA state determination or policy.