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As more Californians talk directly to therapists on the phone on video screens and on the phone, it shows a deeper shift in how mental health care is seeking help as a record setting figure.
Patients and healthcare providers say that Teresalapy is more effective and easier to obtain than in-person services, but experts in the field said that Teresalapy often requires skilled mental health practitioners trained to pick up subtle communication cues.
Almost half of the approximately 4.8 million adults who visited health professionals for mental health or substance use disorders in 2023 did so exclusively through Teresarapy, according to a KFF Health News analysis of the latest data from the UCLA California Health Interview Survey.
A survey of approximately 20,000 households in California found that about 24% of adults used the combination of face-to-face and territoryapia in 2023, while about 23% received direct and exclusive support.
A similar pattern was found in a recent national study of patients in the veteran health system. 55% of mental healthcare continued to be provided via someone who jumped after patients inevitably transitioned to Teresalapia during the COVID-19 pandemic.
Teresarapy is certainly convenient and allows patients to see therapists from the comfort of their home.
“It really works,” said Joshua Heightsman, president of California’s Psychological ASSN. “I think part of that is that it just allows for more comfort. People want to work a little more when they’re comfortable.”
Research that regained it: Teresalapy patients report a similar percentage of patients receiving face-to-face therapy.
“They’re not just about to be able to get into the treatment of people,” said Tao Lin, a researcher at the University of Pennsylvania’s Treatment and Research Treatment Center. This indicates that there is no difference between Teresalapia and in-person therapy.
However, Lynn said it could be difficult for therapists to watch hand movements or read body language during video calls. Lin’s latest research, which has not yet been published, suggests that “increased information loss” means that telephone treatments are “less effective than video conferencing.”
And some people have a hard time connecting with therapists emotionally without meeting them in person, Lynn said. Not uncommon, technical difficulties can interfere with clients building a therapeutic relationship.
David Bain, a resident of Sacramento, relies on Teresarapy to treat depression, as mobility issues make it difficult for therapists to visit in person.
“We’re looking forward to seeing people with mental illnesses,” said Bain, executive director at Nami Sacramento, a nonprofit that provides support and advocacy for people with mental illnesses.
Bain said his one-on-one Teresarapy sessions helped, but he was not very successful in online group therapy. He recently attended a 10-week dialectical behavior therapy class, but he said he had not received the connections and support he received in his previous face-to-face group settings.
“Perhaps there was someone who was actually on screen with me and two or three others,” he said. “Everyone else has removed the screen.”
Teresapie is increasingly offered through mobile phone applications such as Betterhelp and Talkspace. Patients using these applications often pay subscription fees that insurance may be partially covered for regular sessions or contact with the therapist.
UC Irvine researcher Eunkyung Jo co-authored a study examining patient reviews of eight most popular Theresarapy apps published in 2023. While many patients expressed satisfaction with the therapist, the team also revealed a negative pattern.
Some patients often did not receive the treatment they paid for due to technical difficulties. Other patients reported that their therapists had acted indifferent or non-specialist behavior, Joe said they were tied to relatively low-paid therapists who earn on several apps.
Several users also said in reviews that the therapist suddenly disappeared from the app without explanation. She said therapists in more traditional “pay-as-you-go” arrangements rarely discontinue treatment without warning.
Nikole Benders-Hadi, Chief Medical Officer at Talkspace, said patients often get treatment on the platform at the typical cost of a typical $10 Copay. Separately, Talkspace spokesman Jeannine Feyen said therapists have increased in salaries since Jo’s research was conducted, and full-time Talkspace therapists have made between $65,000 and $90,000 a year.
At Betterhelp, therapists earned up to $91,000, and last year the average patient rating for live sessions on the platform was 4.9 out of five, said spokesman Megan Garner. She said the majority of patients reported reliable improvement or remission of symptoms.
The number of Californians visiting health professionals for mental health issues increased by around 434,000 (10%) between 2019 and 2023, UCLA data shows. From 2009 to 2023, approximately 2 million people (69%) jumped.
Still, some remained due to the transition from face-to-face therapy to teletherapy.
UCLA data shows that Californians living within 200% of federal poverty levels (for example, a family of four with a household income of around $60,000 or more in 2023) are unlikely to use Teresapy.
The data also shows that rural residents, who need to provide benefits to telehealth access, were not using it as much as urban residents.
For example, about 81% of San Francisco Bay Area residents who visited health professionals for mental health care in 2023 did so, either fully or in part, through Teresarapy. Approximately 62% of residents in the state’s rural mountain counties did the same.
These disparities suggest gaps seen in remote working patterns. Well-heeled, urban Californians are more likely to work from home than low-income rural residents. Additionally, greater means Californians may have more opportunities to arrange online appointments and feel more comfortable.
In comparison, low-income people tend to go to the office for doctor visits, Heightsman said.
Low-income and rural Californians may also lack the reliable internet services they need for good telehealth. A recent KFF Health News analysis shows millions of Americans live in places with shortages of doctors and inadequate internet access.
Low-income Californians are also likely to live in the tough quarter, making privacy difficult for intimate treatment sessions.
Anyway, teletherapy is currently dominant. And it’s not just the patients who enjoy convenience. Many therapists abandon expensive office rents to work from home.
“Covid allowed that,” Heitzman said. “A lot of people really removed their offices, turned their home into some sort of office, and made them totally happy to be doing it all day.”
This article was produced by KFF Health News, a national newsroom that produces detailed journalism on health issues.
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