Ann Arbor resident Donna Babcock joins her therapy group every week with the press of a button. 

“When the screen goes on, we’re all sitting there in the Zoom meeting,” Babcock added. “Some people are rushing from work, and sometimes your dog comes in and photobombs you, but we’re all laughing. You definitely get to know individuals better (online).”

Babcock’s treatment group, administered by Michigan Medicine, changed to online meetings last March when the COVID-19 pandemic first reached the state. Since the switch, her organization has stayed online, even after massive vaccine implementation.

Allison Lin, an addiction psychiatrist at Michigan Medicine, said she finds a preference for telehealth among patients with fewer resources or who reside in remote areas. 

“If you don’t have a car and it takes you three bus transfers to get to a clinic appointment and you have to do this once a week, that’s just not going to be feasible,” Lin said.

Though Babcock’s therapy group began in person, she claimed a customized dynamic continued during the virtual meetings. According to her, even those who have only experienced the virtual therapy sessions have been able to receive the same support.

“When a person says it’s been a bad week and they start crying, you can just see everybody sort of almost reaching through their screen to comfort them — you can just feel that,” Babcock said. “As the group has gone on, we’ve added new people who we’ve only met online and luckily they seem to come right in and just become accepted right away into the group.”

Medical student Mary Martin grew up in a rural location. She thinks telehealth could enhance access to mental health resources in places like hers because many U.S. counties don’t have mental health professionals.

“I do look forward to using telehealth in the future, given that research suggests it improves access for patients in low-resource communities,” Martin added. “For some patients, (telehealth) is their only option to receive mental health services. For others, the comfort of being in their home fosters engagement in mental health services.”

LSA senior Nick Brdar, executive director of Wolverine Support Network, said he used telehealth with his therapist. He agrees with Martin and stated clinicians may use telehealth as a method to enhance accessibility to mental health care. 

“For a lot of people, there are a lot of barriers to accessing mental health care,” Brdar added. “I see some of those barriers being overcome with telehealth. I see a therapist whose practice isn’t situated in Ann Arbor and … telehealth helped me to discover a provider who was a good fit for me.”

LSA undergraduate Nabeel Mohammad, incoming president of Phi Delta Epsilon, a U-M medical fraternity, said physicians may use telehealth as a method to enhance accessibility to mental health care.

“I’ve seen it firsthand at the doctor’s office I work at — accessibility (to mental health services) is a huge problem,” Mohammad said. “I think that telehealth gives a lot of opportunity to patients that live in rural areas or don’t have access to transportation.” 

As a result of the stigma connected with mental health, Lin stated mental health-related conditions tend to be the most untreated health care conditions. According to the Surgeon General, only around 10 percent of individuals with a substance use disorder seek help; a portion of that gap is related to this stigma.

Lin said she feels telehealth may be a technique clinicians might utilize to alleviate this stigma. Physically accessing a doctor’s office may be a barrier for others, Lin said, therefore offering telemedicine is vital.

“It’s really hard sometimes for our folks to even pick up the phone and call for help because there’s a stigma,” Lin added. “Someone that attends a treatment visit on their lunch break and is able to call in and talk to their therapist about a pretty sensitive topic … may reduce some of the stigma, which we know is a barrier for treatment.”

Although mental health therapies via telehealth became more available during the pandemic, experts noted a spike in substance usage and overdose rates. University President Mark Schlissel also noticed an uptick in mental health and alcohol-related hospital visits in an Oct. 29 University-wide email.

“This past week, a higher percentage of student emergency department visits were related to mental health and alcohol than in prior weeks,” Schlissel stated. “So please reach out and ask for help if you need it.”

Lin underlined that those with mental health issues were disproportionately impacted during the pandemic. She noted that establishing new forms of telehealth can assist clinicians to tackle the surge in mental health and substance misuse disorders.

“Folks with mental health and substance use disorders I think had greater struggles (during the pandemic), and (the pandemic) likely exacerbated their symptoms and their substance abuse,” Lin said. “We really need to think about how to improve the way we deliver care for all of these folks. How do we actually better reach people, make care more accessible, less stigmatizing so that we may change the needle on how many people are seeking help.”

One challenge that remains in telehealth is internet connectivity, according to Martin. She said many persons in her rural village relied on public internet hotspots to listen to treatment sessions. 

“I grew up in a rural Appalachian area with scattered Wi-Fi deserts,” Martin added. “While I do have access to Wi-Fi at home, the Wi-Fi is unreliable. I have taken meetings and even appointments from a McDonald’s parking lot … some pupils finished their whole elementary school curriculum during the pandemic in a McDonald’s parking lot.” 

Although Babcock would prefer to see her therapy group in person, she said she still looks forward to virtual meetings.

“I think telehealth is here to stay,” Babcock added. “We were sort of hoping to (be in person) just so we have a chance to give a hug. But I think it’s going to be partly telehealth and some in person.”

Brdar said he believes telehealth will stay, but he proposed that mental health care may be given via a hybrid model in the future. He stated that some difficulties with telemedicine need to be addressed, like patient confidentiality for people who attend telehealth visits in a shared living area. 

“It’s tough to find spaces to take telehealth appointments,” Brdar remarked. “A lot of students in Ann Arbor don’t live alone. Even if you’re in your bedroom taking those therapy or psychiatry calls, I think there’s the worry of breaking confidentially with roommates around.”

Lin said she is also hoping that telehealth will remain as an option for patients, but is apprehensive that when pandemic restrictions loosen, telehealth may be rolled back. Lin said that more research into the effectiveness of telehealth is needed.

“I’m hoping that the policy will continue to be evidence-based because one of the problems is that there hasn’t been enough research (into telehealth),” Lin said. “A lot of patients are now used to telehealth. No matter what we do, we just have to make sure that there’s a lot of flexibility and meeting people where they’re at.”