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Columbia University Researchers Find Disparities in Telehealth Accessibility
Despite the rapid expansion of teletherapy services over recent years, a study from a team of psychiatrists at Columbia University reveals that telehealth has not increased access to mental health care for individuals who cannot afford it. The study, published in the American Journal of Psychiatry, draws from extensive data and reveals that, while teletherapy has become widely accessible, it has not effectively bridged the gap for low-income communities.
The study explores trends in psychotherapy usage, particularly during and after the pandemic, when teletherapy became a mainstay due to its convenience and ability to reach patients remotely. While the overall percentage of Americans receiving psychotherapy rose from around 3% to 4% pre-pandemic to about 8.5% during the pandemic, the increase in use has not been evenly distributed across socioeconomic groups.
Researchers revisited a prior study involving 89,619 psychotherapy patients, finding that teletherapy’s primary adopters were young, well-educated, and affluent individuals. This trend was further supported by a secondary analysis of telehealth use by children and adolescents, which indicated that those accessing mental health services were mostly from high-income families with robust health insurance.
Despite the promise of telehealth to provide greater access, the findings suggest that financial barriers persist. Psychotherapists, expecting to be compensated in the same manner as for in-office sessions, typically rely on clients or insurance companies to cover costs. This means that low-income individuals, who may not have access to affordable insurance or the means to pay for such services out-of-pocket, are often left without options.
The research highlights an ongoing challenge in the field of mental health care: the widening gap in access between higher-income individuals and those who face financial constraints. As teletherapy continues to expand, the study’s authors argue that efforts should be made to better address the needs of vulnerable populations, particularly through subsidies, insurance reform, and policies aimed at reducing the cost of care.
This study underscores the need for further exploration into how telehealth can be made truly equitable, ensuring that all individuals, regardless of their financial background, can access the mental health services they need.
Source: Mark Olfson et al, “Use of Telemental Health Care by Children and Adolescents in the United States,” American Journal of Psychiatry, 2025. DOI: 10.1176/appi.ajp.20240193
