Telepsychiatry Use Before and During the COVID-19 Pandemic Among Children Enrolled in Medicaid.

Objective: This study examined telepsychiatry use among children enrolled in Medicaid before and during the COVID-19 pandemic.

Methods: A retrospective analysis was conducted of claims data from the Transformed Medicaid Statistical Information System for children (ages 3-17) with any mental health service use in 2019 (N=5,606,555) and 2020 (N=5,094,446).

Results: The number of children using mental health services declined by 9.1% from 2019 to 2020. Mental health services in all care settings (inpatient, outpatient, residential, emergency department, intensive outpatient/partial hospitalization) declined except for telehealth, which increased by 829.6%. In 2020, 44.5% of children using telehealth were non-Hispanic White, 16.1% were non-Hispanic Black, and 19.7% were Hispanic. Attention-deficit hyperactivity disorder, trauma, anxiety, depression, and behavior/conduct disorder were the most prevalent psychiatric diagnoses among children using telehealth services.

Conclusions: Although telehealth use increased substantially in 2020, overall mental health service use declined among Medicaid-enrolled children. Telehealth may not fully address unmet mental health service needs.