Telemental health services

There is some evidence that telemental health services improve mental health (Barnett 2021, Osenbach 2013, Dorstyn 2013, Sloan 2011, Hailey 2008) at least as effectively as in-person treatment for a range of conditions (Kelber 2025, Chen 2024a, Krzyzaniak 2024, Hagi 2023, Philippe 2022), especially when provided synchronously (Philippe 2022). Telemental health services appear to improve access to care (Chen 2024a, Philippe 2022, Hagi 2023) though additional evidence is needed to confirm effects on access among different patient groups, as well as on using telemental health to treat understudied mental health conditions (Philippe 2022, Barnett 2021). Studies of audio-only, hybrid in-person and tele-services (Sugarman 2023), and longer treatments are also needed (Hagi 2023).

Telepsychiatry can be more effective than in-person treatment for depressive disorders, especially over a longer treatment period, and for mild cognitive impairments (Hagi 2023). Telepsychiatry refers to psychiatric consultation and counseling via remote videoconferencing (Hagi 2023). Telemedicine appears comparable to in-person treatment to manage common disorders like stress, depression, and anxiety (Chen 2024a, Krzyzaniak 2024, Osenbach 2013, Dorstyn 2013, Sloan 2011, Hailey 2008). Therapy or counseling provided via telemental health services is comparable to in-person treatment for anxiety and related conditions, such as obsessive compulsive disorder (OCD); a study of treatment with cognitive behavioral therapy (CBT) or graded exposure and response prevention therapy finds no difference in outcomes, reported working alliance (by therapist or client), or in client satisfaction (Krzyzaniak 2024). Telemental health treatment for families, where parental depression is the focus, may be more effective than in-person treatment (Sugarman 2023). Telemental health services may be appropriate for individuals with autism spectrum disorders or social anxiety as it reduces stimuli, stress about social interactions, and the need for eye contact (Philippe 2022).

For patients with post-traumatic stress disorder (PTSD), video teleconferencing appears comparable to in-person treatment (specifically, prolonged exposure and cognitive processing therapy), though experts note that which primary symptom or diagnosis is being treated may affect outcomes (Kelber 2025). Telemental health services may be less appropriate for individuals with schizophrenia and psychosis disorders, who report feeling monitored or recorded; some may refuse care (Philippe 2022). Telemental health services appear less effective at treating patients with eating disorders and those with substance use disorders, who may be more likely to discontinue treatment (Hagi 2023). More research is also needed regarding telemental health services use by patients at risk for suicide or violence (Philippe 2022).

Synchronous and asynchronous care. Telemental health services for treatment and assessment, provided synchronously, appear to be as effective as in-person treatment for many conditions (Philippe 2022, Barnett 2021), and videoconferencing appears to be acceptable to patients, at least in the short-term (Barnett 2021). Most patients report that synchronous telemental health services improve their access to care as well as feelings of independence and self-expression (Philippe 2022). Asynchronous care, in which the patient and provider communicate when they have time – usually not directly – is recommended for activities like sending patient reminders and offering support to reduce a patient’s risk of relapse, but is not recommended as a sole means of telemental health care (Philippe 2022). Experts note possible limitations with audio-only telemental health services, such as a lack of non-visual verbal cues, and that more research is needed which compares audio-only, or audio-only plus in-person treatment, with standard in-person treatments (Sugarman 2023).

Recommendations. Overall, telemental health programs and services which offer a combination of care approaches (Appleton 2023), for example, including some contact with a therapist for feedback and follow-up, appear to be more effective than less comprehensive programs and those that do not involve therapist contact (Penate 2012, Appleton 2023). Telemental health services may be more effective when treating mild or moderate symptoms, rather than more severe symptoms (Penate 2012). Providers should also use informed consent and follow guidance to ensure their practice offers a standard of care equivalent to in-person treatment and meets the same ethical and professional standards. Guidance includes assessing patients’ suitability for telemental health care as well as whether both patient and provider have adequate privacy, technology, and knowledge about the nearest emergency health care facility (Sugarman 2023). Experts also recommend providers be trained in prevention and reporting of adverse events for clients during assessment and care, noting that additional monitoring and reporting of such events in telemental health practices is needed (Martiniuk 2023).

Best practices for providing telemental health services via videoconferencing include using platforms with security and confidentiality features and through which recording is not possible (NIMH-Telemental). Experts also recommend that providers offer initial free consultations to help patients determine if the provider is a good fit, which can be more difficult to tell in a virtual environment (NIMH-Telemental). Providers appear to be able to develop comparably effective therapeutic relationships using telemental health technology as in-person. Experts suggest that treating patients while they are in their homes may allow providers to see and better understand patients’ home environments, which may make treatment approaches more effective (Hagi 2023), while the geographic distance between providers and patients reduces providers’ risk of physical confrontation (Philippe 2022).

Costs. Synchronous forms of telemental health care, such as videoconferencing telepsychiatry, appear favorable, with potential savings in time, costs, and patient travel (Philippe 2022, Pesamaa 2004). One study of telephone care management and cognitive behavioral therapy found only a modest increase in the cost of services compared to usual primary care (Simon 2009), although additional study is needed to confirm effects on cost (RAND-Brown 2015).

Environmental benefits. Telemental health services have the potential to reduce the carbon footprint of the health care industry, primarily by reducing vehicle miles traveled (VMT) and greenhouse gas emissions from patients driving to appointments. Telemental health appointments generate some carbon emissions and those amounts vary based on the length of the appointment, type of teleconferencing platform used, energy used to support the virtual connection, and different broadband capacities. In general, telemental health appointments that replace a car trip of a few kilometers or more reduce carbon emissions (Dacones 2021, Yellowlees 2022, Philippe 2022, Holmner 2014).

Telemental health services are a suggested strategy to increase access to mental health care for those who experience geographic or other barriers to accessing in-person care (Sugarman 2023, Hagi 2023). More research is needed to confirm what telemental health services are most effective and appropriate for those who experience marginalization or other barriers to accessing telemental health interventions (Boswell 2025, Philippe 2022, Hensel 2019, RAND-Uscher Pines 2023), including for individuals accessing care at federally qualified health centers (FQHCs) (RAND-Uscher Pines 2023). Experts suggest that for telemental health services to decrease disparities, initiatives be tailored to promote cultural competence and equity in mental health care, particularly racial-ethnic equity (Boswell 2025, Ruiz-Consignani 2024).

Experts recommend that telemental health services remain a routine approach to increase access to care, with experts noting that a physical exam is not typically required and that such services reduce barriers to attending appointments in-person, such as geographic distances, caregiving and employment schedules (Sugarman 2023). Experts note telepsychiatry is critical for individuals in locations with fewer providers and for individuals who experience challenges with clinic visits due to their mobility or symptoms (Hagi 2023). Telepsychiatry may also contribute to early intervention and care coordination (Hagi 2023).

Telemental health use, as with telemedicine generally, varies by geography, socioeconomic status, and among those with minoritized backgrounds, as well as between urban, rural, and suburban settings (Sugarman 2023, Boswell 2025). Available evidence suggests that prior to the COVID-19 pandemic, telemental health service use appeared to be increasing among Medicare beneficiaries in rural areas and among populations with the most barriers to access, potentially reducing long-standing disparities in care receipt (Sugarman 2023). In 2021-2022, however, rural residents continued to report lower usage of telemental health, despite rural and large metro residents appearing similarly likely to receive mental health care (inpatient, outpatient, and prescription services) (Boswell 2025).

Telemedicine overall is a suggested strategy to decrease geographic disparities in access to health care between rural and urban areas (Shaver 2022) by improving access for rural populations and in areas with medical provider shortages (Quayson 2024, Shigekawa 2018, Bashshur 2016). Two U.S.-based studies looking at the telemedicine expansion during 2021 and 2022, suggest disparities in use may have decreased compared to the beginning of the COVID-19 pandemic, finding similar usage rates for telemedicine generally by age, race, ethnicity, income, urban/rural location (Spaulding 2024) and education (Chang 2024). However, disparities persist in video-enabled compared with audio-only visits as well as health care online portal use (Sheon 2026). A California-based study finds that rates of audio-only telehealth appointments remain high, even after the COVID-19 pandemic, especially among individuals with lower incomes and clients of FQHCs (RAND-Uscher Pines 2023); it is unclear whether wide use of audio-only among these groups is appropriate (RAND-Uscher Pines 2023).

Disparities in mental health exist in the U.S. within racially, ethnically (Sharifian 2024), gender (Mongelli 2020), and geographically (McCarthy 2024) diverse civilian populations, as well as among service members and veterans, compared with those at less risk because of their identity, military service status (Sharifian 2024), or community type (McCarthy 2024). Mental health provider shortages persist in historically redlined neighborhoods (Boswell 2025), and major barriers to access to telemental health include that not all mental health providers accept Medicaid, and disparities in internet access and insurance coverage persist (Boswell 2025).

Participation in telecounseling can reduce depression and anxiety, and improve quality of life among groups who are racially or ethnically minoritized, at least in the short-term (Dorstyn 2013). Video teleconferencing may be comparable to in-person treatment for PTSD (Kelber 2025). Among veterans, both videoconferencing and audio-only treatment appear comparable to in-person treatment for anxiety and depression, and videoconferencing is as effective for a wider range of conditions, but in-person treatment may be modestly more helpful for trauma treatment (Sugarman 2023). Telemental health services may also be effective among individuals experiencing homelessness or unstable housing (DeLaCruz-Jiron 2023). However, women who are Black and experiencing poverty are least likely to use telehealth, even as advances have been made among other populations and across a broad range of conditions (Saeed 2021).

An Australia-based review suggests telemental health care may reduce disparities in mental health status experienced by Indigenous individuals, increase access to specialist care for individuals in geographically remote areas, and offers cost savings from reduced travel (Caffery 2017). However, such outcomes are possible only if providers are educated about and if services reflect Indigenous values and local needs (Hensel 2019). More research is needed to confirm which telemental health services are most effective and appropriate for patients who are from Indigenous backgrounds (Hensel 2019), who often experience less availability of and access to mental health services (Ruiz-Consignani 2024).

Experts recommend creating services which are culturally safe, meaning care that is adapted or designed especially for individuals from a specific minoritized background (Ruiz-Consignani 2024). For example, components to establish a culturally safe telepsychiatry practice in an Indigenous community include, as a first step, directly consulting and involving local community members and organizations in order to identify needs and initial adaptations; pilot testing with feedback from multiple sources and further adaptation; and trial provision of care, with the understanding that adaptation is an ongoing process (Ruiz-Consignani 2024). Some principles of culturally safe care overlap with initiatives for patient-centered care (Terrill 2023). Access to care in one’s native and preferred languages, as well as culturally-concordant care, impacts treatment initiation and continuation (Boswell 2025). For some people, including some individuals with Indigenous backgrounds, in-person mental health treatment will always be preferable (Terrill 2023).

Research on mental health interventions with digital components, including audio-based telehealth, recommends tailoring to intersecting factors including LGBTQIA+ status, geography, and individuals’ racial background and considering co-occurrence of LGBTQIA+ with neurodivergence (Fowler 2023).

Challenges contributing to disparities in access to telemental health care can include technical considerations, like broadband service or internet access and speed, suitable devices, and geographic distance (Ruiz-Consignani 2024). Improvements to infrastructure to increase access to telemedicine should consider telemental health services as well (Boswell 2025).

Early advocates for telemedicine pointed to its potential to improve access, quality, and affordability of care, reducing disparities between populations in health care receipt (Bashshur 1995). Telemedicine was initially used for acute conditions, such as strokes or traumatic injuries, to connect specialist providers with clinicians treating patients in emergency departments. Telemedicine programs have also historically focused on rural populations, as well as those in the military and individuals who are incarcerated (Dorsey 2016). Before March 2020 and the onset of the COVID-19 pandemic in the U.S., provider-patient telemedicine use was increasing but was a tiny proportion of overall care (Shaver 2022), especially video-enabled visits (Dorsey 2016). Most patients in the U.S. who used telemedicine did so through large academic medical centers, the Veterans Administration (VA) health systems, or purchased access if their health care provider offered direct-to-consumer services. Barriers to internet access and use prevented patients in rural areas, those with lower household incomes, disabilities (Shaver 2022), and older adults from accessing care via telemedicine (Dorsey 2016). Legal barriers and differing state rules, such as whether medication could be prescribed over the internet, also restricted use (Dorsey 2016).

In March 2020, to support access to care and financial solvency for health care systems, Congress adjusted telemedicine restrictions for Medicare, which included removing some restrictions for reimbursement, geography, and platform, as well as including telephone-only visits, and addressed interstate barriers to practice and privacy related to states’ differing rules, with state and private health insurance payors following this example (Shaver 2022). A study of private and Medicare health care claims estimates that telehealth claims increased from 0.1% in 2019 to 5% of overall claims as of 2021 (Shaver 2022). Barriers in access to care for mental illness are a problem worldwide, and estimates for the U.S. suggest that less than half of individuals with mental illness receive treatment (Sugarman 2023).

• Who has access to mental health services in your community and who does not? How could telemental health help remove barriers (e.g., health insurance coverage, internet access) so more people can access services?
• Who is choosing which types of telemental health services to offer patients and how are those decisions being reached? Which health needs are the focus? Which patient groups?
• How are health care providers, as well as community members, engaged in efforts to expand telemental health use? What local or state laws and regulations restrict its use?

As of September 2025, all 50 states, Washington, D.C., and Puerto Rico provide Medicaid and Medicare reimbursement for live video telehealth services, while 46 states and Washington D.C.’s programs also provide reimbursement for audio-only telehealth; in both cases, what is reimbursed varies (CCHP-Telehealth policy maps). Similarly, 44 states and Washington, D.C. have telehealth private payer laws (CCHP-Telehealth policy maps). The U.S. Department of Health and Human Services National Institute of Mental Health (NIMH) has information about finding a health care provider that offers telemental health services (NIMH-Telemental). Comprehensive guidelines and toolkits for telemental health care provision are available from organizations including the American Psychological Association, American Psychiatric Association, American Telemedicine Association (ATA), the World Psychiatric Association (WPA), and the American Academy of Child and Adolescent Psychiatry (AACAP) (Sugarman 2023).

The Veterans Administration (VA) health system includes telemental health care (VA.gov-Mental Health). VA programming to support access to telemedicine generally includes Digital Divide Consult, a consulting system to connect veterans with social workers to troubleshoot and connect them with discounts and devices (Cruise 2025). The VA also loans remote health monitoring devices and maintains centers with health technology experts to support veterans, their families and caregivers, and VA staff in using VA telehealth tools and technology (Cruise 2025). The VA’s Anywhere to Anywhere initiative (ATLAS – Accessing Telehealth through Local Area Stations) connects veterans living far from the VA with a location set up for private telehealth so that home internet is not a barrier (Cruise 2025).

The Indian Health Service recognizes telemedicine and telemental health as essential to care delivery in communities and provides services across the country through the Telebehavioral Health Center of Excellence (TBHCE), including videoconferencing psychiatry and therapy appointments for patients at participating facilities (IHS.gov-Telebehavioral).

The U.S. has an interstate compact which makes telepsychology services (and temporary in-person services) from licensed psychologists available across state boundaries, called the Psychology Interjurisdictional Compact (PSYPACT) (PSYPACT-About). The PSYPACT Commission, with representatives from multiple states, authorizes psychologists’ interstate practice (PSYPACT-About). As of 2024, nearly all states participate, with only a handful of states and territories lacking active legislation to join the compact (Oregon, California, New Mexico, Guam, Puerto Rico, and the U.S. Virgin Islands) (PSYPACT-Map).

Legislation has been introduced in some states which would allow providers not approved by the PSYPACT Commission to practice across state lines (WI AB 541). Such legislation was vetoed in Wisconsin in 2024, citing the existing compact and concerns that consumers would have difficulty filing complaints against providers in other states, where consumers’ home state agencies for credentialing and safety have no jurisdiction (WI AB 541-Veto).

‡ Resources with a focus on equity.

AACAP-Telepsychiatry - The American Academy of Child and Adolescent Psychiatry (AACAP). The Child and Adolescent Telepsychiatry Toolkit.

APA-Telepsychiatry - American Psychiatric Association (APA). APA Work Group on Telepsychiatry: Telepsychiatry Toolkit.

CCHP^‡ - Center for Connected Health Policy (CCHP).

HRSA-HHS Telehealth licensing^‡ - Health Resources & Services Administration (HRSA). Telehealth.HHS.gov. Licensing across state lines.

NIMH-Telemental^‡ - National Institute of Mental Health (NIMH): Getting mental health support virtually. U.S. Department of Health and Human Services (U.S. DHHS), National Institutes of Health (NIH).

PSYPACT-Map^‡ - Psychology Interjurisdictional Compact (PSYPACT). Participating states.

VA-Atlas - U.S. Department of Veterans Affairs (VA). (n.d.). VA Atlas (Accessing Telehealth Through Local Area Stations). Retrieved May 29, 2026.

* Journal subscription may be required for access.

Appleton 2023 - Appleton R, Barnett P, San Juan NV, et al. Implementation strategies for telemental health: A systematic review. BMC Health Services Research. 2023;23(78):1-24.

Barnett 2021 - Barnett P, Goulding L, Casetta C, et al. Implementation of telemental health services before COVID-19: Rapid umbrella review of systematic reviews. Journal of Medical Internet Research. 2021;23(7):e26492.

Bashshur 1995* - Bashshur, R. L. (1995). On the definition and evaluation of telemedicine. Telemedicine Journal, 1(1), 19-30.

Bashshur 2016 - Bashshur RL, Howell JD, Krupinski EA, et al. The empirical foundations of telemedicine interventions in primary care. Telemedicine and e-Health. 2016;22(5):342-375.

Boswell 2025* - Boswell, E. K., Hung, P., Zhang, J., & Crouch, E. L. (2025). Sociodemographic disparities in
mental health care settings among adults. Psychiatric Services, 76(11), 959-969.

Caffery 2017* - Caffery LJ, Bradford NK, Wickramasinghe SI, Hayman N, Smith AC. Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres Strait Islander people: A systematic review. Australian and New Zealand Journal of Public Health. 2017;41(1):48-53.

CCHP-Telehealth policy maps - Center for Connected Health Policy (CCHP). (n.d.). Telehealth policy trend maps. Retrieved June 25, 2025.

Chang 2024 - Chang, E., Penfold, R. B., Berkman, N. D. (2024). Patient characteristics and telemedicine use in the U.S., 2022. JAMA Network Open, 7(3), e243354.

Chen 2024a* - Chen, J., Li, C., An, K., Dong, X., Liu, J., & Wu, H. (2024). Effectiveness of telemedicine on
common mental disorders: An umbrella review and meta-meta-analysis. Computers in
Human Behavior, 159, 108325.

Cruise 2025 - Cruise, C. (2025). Overview of telehealth in the Department of Veterans Affairs. American Journal of Audiology, 34(4), 781-784.

Dacones 2021* - Dacones I, Cave C, Furie GL, Ogden CA, Slutzman JE. Patient transport greenhouse gas emissions from outpatient care at an integrated health care system in the Northwestern United States, 2015–2020. The Journal of Climate Change and Health. 2021;3.

DeLaCruz-Jiron 2023* - DeLaCruz-Jiron EJ, Hahn LM, Donahue AL, Shore JH. Telemental health for the homeless population: Lessons learned when leveraging care. Current Psychiatry Reports. 2023;25:1-6.

Dorsey 2016* - Dorsey ER, Topol EJ. State of telehealth. New England Journal of Medicine. 2016;375(2):154-161.

Dorstyn 2013* - Dorstyn DS, Saniotis A, Sobhanian F. A systematic review of telecounselling and its effectiveness in managing depression amongst minority ethnic communities. Journal of Telemedicine and Telecare. 2013;19(6):338-346.

Fowler 2023* - Fowler, J. A., Buckley, L., Muir, M., Viskovich, S., Paradisis, C., Zanganeh, P., & Dean, J.
A. (2023). Digital mental health interventions: A narrative review of what is important from
the perspective of LGBTQIA+ people. Journal of Clinical Psychology, 79, 2685–
2713.

Hagi 2023 - Hagi K, Kurokawa S, Takamiya A, et al. Telepsychiatry versus face-to-face treatment: Systematic review and meta-analysis of randomised controlled trials. British Journal of Psychiatry. 2023;223(3):407-414.

Hailey 2008* - Hailey D, Roine R, Ohinmaa A. The effectiveness of telemental health applications: A review. Canadian Journal of Psychiatry. 2008;53(11):769-78.

Hensel 2019 - Hensel JM, Ellard K, Koltek M, Wilson G, Sareen J. Digital health solutions for indigenous mental well-being. Current Psychiatry Reports. 2019;21:68.

Holmner 2014 - Holmner Å, Ebi KL, Lazuardi L, Nilsson M. Carbon footprint of telemedicine solutions - Unexplored opportunity for reducing carbon emissions in the health sector. PLoS ONE. 2014;9(9).

IHS.gov-Telebehavioral - Indian Health Service (IHS). (n.d.). Telebehavioral Health Center of Excellence (TBHCE). Retrieved May 18, 2026.

Kelber 2025* - Kelber, M. S., Smolenski, D. J., Boyd, C., Shank, L. M., Bellanti, D. M., Milligan, T., ... & Evatt, P. (2025). Evidence-based telehealth interventions for post-traumatic stress disorder, depression, and anxiety: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 31(6), 757-767.

Krzyzaniak 2024* - Krzyzaniak, N., Greenwood, H., Scott, A. M., Peiris, R., Cardona, M., Clark, J., & Glasziou, P. (2024). The effectiveness of telehealth versus face-to face interventions for anxiety disorders: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 30(2), 250-261.

Lambert 2013 - Lambert D, Gale J, Hansen AY, Croll Z, Hartley D. Telemental health in today’s rural health system. Portland, ME: Maine Rural Health Research Center, University of Southern Maine Muskie School of Public Service. 2013:PB-51.

Martiniuk 2023 - Martiniuk A, Toepfer A, Lane-Brown A. A review of risks, adverse effects and mitigation strategies when delivering mental health services using telehealth. Journal of Mental Health. 2023:1-24.

McCarthy 2024* - McCarthy MJ, Wicker A, Roddy J, et al. Feasibility and utility of mobile health interventions for depression and anxiety in rural populations: A scoping review. Internet Interventions. 2024;35(January):100724.

Mongelli 2020 - Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus (American Psychiatric Publishing), 18(1), 16–24.

NIMH-Telemental - National Institute of Mental Health (NIMH): Getting mental health support virtually. U.S. Department of Health and Human Services (U.S. DHHS), National Institutes of Health (NIH).

Osenbach 2013 - Osenbach JE, O’Brien KM, Mishkind M, Smolenski DJ. Synchronous telehealth technologies in psychotherapy for depression: A meta-analysis. Depression and Anxiety. 2013;30(11):1058-67.

Penate 2012 - Peñate W. About the effectiveness of telehealth procedures in psychological treatments. International Journal of Clinical and Health Psychology. 2012;12(3):475-487.

Pesamaa 2004* - Pesamaa L, Ebeling H, Kuusimaki ML, et al. Videoconferencing in child and adolescent telepsychiatry: A systematic review of the literature. Journal of Telemedicine and Telecare. 2004;10(4):187-192.

Philippe 2022 - Philippe TJ, Sikder N, Meng AJ, et al. Digital health interventions for delivery of mental health care: Systematic and comprehensive meta-review. JMIR Mental Health. 2022;9(5):e35159.

PSYPACT-About - Psychology Interjurisdictional Compact (PSYPACT). Overview.

PSYPACT-Map - Psychology Interjurisdictional Compact (PSYPACT). Participating states.

Quayson 2024 - Quayson, B. P., Hough, J., Boateng, R., Boateng, I. D., Godavarthy, R., & Mattson, J. (2024). Telehealth for rural veterans in the United States: A systematic review of utilization, cost savings, and impact of COVID-19. Societies, 14(12), 264.

RAND-Brown 2015 - Brown RA, Marshall GN, Breslau J, et al. Access to behavioral health care for geographically remote service members and dependents in the U.S. Santa Monica: Rand Corporation; 2015.

RAND-Uscher Pines 2023 - Uscher-Pines L, McCullough CM, Sousa JL, et al. Changes in in-person, audio-only, and video visits in California’s federally qualified health centers, 2019-2022. Santa Monica: RAND Corporation; 2023.

Ruiz-Consignani 2024* - Ruiz-Cosignani D, Chen Y, Cheung G, et al. Adaptation models, barriers, and facilitators for cultural safety in telepsychiatry: A systematic scoping review. Journal of Telemedicine and Telecare. 2024;30(3):466-474.

Saeed 2021 - Saeed SA, Masters RM. Disparities in health care and the digital divide. Current Psychiatry Reports. 2021;23:61.

Sharifian 2024 - Sharifian N, Kolaja C, LeardMann CA, et al. Racial and ethnic mental health disparities in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. American Journal of Epidemiology. 2024;193(3):500-515.

Shaver 2022 - Shaver J. The state of telehealth before and after the COVID-19 pandemic. Primary Care: Clinics in Office Practice. 2022;49(4):517-530.

Sheon 2026 - Sheon, A., & Khoon, E. C. (2026). Digital inclusion pathways to health equity. Health Affairs Health Policy Brief.

Shigekawa 2018 - Shigekawa E, Fix M, Corbett G, Roby DH, Coffman J. The current state of telehealth evidence: A rapid review. Health Affairs. 2018;37(12):1975-1982.

Simon 2009 - Simon GE, Ludman EJ, Rutter CM. Incremental benefit and cost of telephone care management and telephone psychotherapy for depression in primary care. Archives of General Psychiatry. 2009;66(10):1081-9.

Sloan 2011* - Sloan DM, Gallagher MW, Feinstein BA, Lee DJ, Pruneau GM. Efficacy of telehealth treatments for posttraumatic stress-related symptoms: A meta-analysis. Cognitive Behaviour Therapy. 2011;40(2):111-25.

Spaulding 2024 - Spaulding, E. M., Fang, M., Commodore-Mensah, Y., … & Coresh, J. (2024). Prevalence and disparities in telehealth use among U.S. adults following the COVID-19 pandemic: National cross-sectional survey. Journal of Medical Internet Research, 26, e52124.

Sugarman 2023* - Sugarman DE, Busch AB. Telemental health for clinical assessment and treatment. BMJ. 2023;380:e072398.

Terrill 2023* - Terrill K, Woodall H, Evans R, et al. Cultural safety in telehealth consultations with Indigenous people: A scoping review of global literature. Journal of Telemedicine and Telecare. 2023.

VA.gov-Mental Health - U.S. Department of Veterans Affairs (VA). (n.d.). Health care: Mental health. Retrieved May 18, 2026.

WI AB 541 - Representatives Gustafson, Dittrich, Kitchens, et al. Wisconsin State Legislature. 2023 Assembly Bill (AB) 541.

WI AB 541-Veto - Wisconsin State Legislature. Assembly Bill (AB) 541. Governor’s veto message. March 29, 2024.

Yellowlees 2022 - Yellowlees P. Climate change impacts on mental health will lead to increased digitization of mental health care. Current Psychiatry Reports. 2022;24:723-730.