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Telehealth Settings: Telebehavioral Health & Mental Health

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Telehealth Settings: Telebehavioral Health & Mental Health

Introduction

Telebehavioral health refers to the delivery of behavioral and mental health services using telehealth technologies, including psychiatry, therapy, counseling, assessment, care coordination, and follow-up services provided through secure video, audio-only, or asynchronous platforms. Telebehavioral health has become a critical care delivery modality for expanding access to services across the lifespan. Workforce shortages, long wait times, geographic barriers, and stigma continue to limit access to in-person mental health care, particularly in rural and underserved communities.

Telehealth enables individuals to receive timely, confidential behavioral health services in settings that are convenient and familiar, while supporting providers and organizations in addressing access, capacity, and continuity of care challenges.

Telehealth Applications in Telebehavioral Health & Mental Health Settings

Telehealth is widely used across behavioral and mental health care delivery, including:

  • Telepsychiatry
    Psychiatric evaluations, medication management, and follow-up care delivered via synchronous video visits across outpatient, inpatient, emergency, and community-based settings.
  • Virtual Therapy and Counseling
    Individual, group, and family therapy provided by licensed behavioral health clinicians, including services for anxiety, depression, trauma, substance use disorders, and serious mental illness.
  • Crisis and Emergency Behavioral Health Support
    Telebehavioral health services used in emergency departments, crisis centers, mobile crisis units, and community settings to support assessment, stabilization, and disposition planning.
  • Integrated Behavioral Health
    Telehealth-enabled behavioral health services embedded within primary care, rural hospitals, school-based settings, and post-acute care environments.
  • Care Coordination and Follow-Up
    Virtual follow-up visits, care management, and coordination with primary care, social services, and community supports to improve continuity of care.
  • Asynchronous Services and eConsults
    eConsults and other asynchronous models that allow primary care or community providers to seek specialist behavioral health input without requiring real-time visits.

Clinical Guidelines & Best Practices for Telebehavioral Health

Delivering behavioral and mental health services via telehealth requires attention to clinical quality, patient experience, and ethical practice. The following best practices support safe, effective, and patient-centered telebehavioral health care across settings and populations:

  • Use person-first, inclusive, and non-stigmatizing language
    Clinicians and organizations should use language that is respectful, culturally responsive, and trauma-informed. This includes avoiding stigmatizing terms, using person-first language, and adapting communication to meet patient preferences and needs.
  • Establish clear informed consent and expectations
    Patients should understand what telebehavioral health is, how sessions will be conducted, privacy considerations, and what to do in case of technical issues or emergencies.
  • Ensure privacy, confidentiality, and safety
    Telebehavioral health visits should be conducted in private environments, using secure platforms, with clear protocols for managing safety concerns, including suicidality or crisis situations.
  • Apply evidence-based clinical standards
    Telebehavioral health services should follow the same clinical standards as in-person care, including appropriate assessment, documentation, care planning, and follow-up.
  • Plan for crisis response and escalation
    Clinicians should have clear protocols for managing emergencies, including identifying patient location, accessing local crisis resources, and coordinating with in-person services when needed.
  • Support access and equity
    Programs should consider barriers related to broadband, devices, language access, disability, and digital literacy, and offer accommodations such as audio-only visits or interpreter services when appropriate.
  • Promote continuity and coordination of care
    Telebehavioral health services should be integrated with primary care, emergency services, and community supports to ensure continuity of care.
  • Provide clinician training and support
    Ongoing training in telebehavioral health delivery, virtual engagement techniques, trauma-informed care, and cultural humility helps maintain quality and reduce clinician burnout.
  • TeleMAT and tele-substance use treatment considerations
    Telehealth can support medication-assisted treatment (MAT) and other substance use disorder (SUD) services, including assessment, counseling, care coordination, and ongoing monitoring. TeleMAT programs should follow evidence-based clinical guidelines, address prescribing and monitoring requirements, support patient engagement and retention, and coordinate closely with in-person services, pharmacies, and community-based supports. Trauma-informed, non-stigmatizing language and harm-reduction approaches are especially important when delivering SUD services via telehealth.
  • Monitor quality and outcomes
    Use data to assess access, patient experience, clinical outcomes, and equity, and apply continuous quality improvement practices.
    Example metrics may include:
    • Time to first behavioral health appointment
    • No-show and dropout rates
    • Patient-reported outcomes and experience measures
    • Crisis escalations or ED diversions
    • Provider satisfaction and retention

Federal and State Law & Policy Considerations

Telebehavioral health policies vary by state, payer, and care setting. Organizations should review applicable federal and state requirements when implementing or expanding services.

Key considerations include:

  • Medicare and Medicaid coverage for telebehavioral health services
  • Provider licensure and supervision, including interstate practice requirements
  • Privacy, consent, and confidentiality, particularly for sensitive behavioral health information
  • Prescribing regulations, including requirements related to controlled substances
  • Crisis care and emergency protocols for virtual settings

Because behavioral health policies continue to evolve, organizations should monitor updates at both the federal and state levels.

Policy Resources & Guidance


Setting-Specific Resources: Telebehavioral Health & Mental Health


Regional Highlights & Resources

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