Cutler Institute for Health and Social Policy

Telemental Health in Today's Rural Health System


Telemental health has long been promoted in rural areas to address chronic access barriers to mental health care. While support and enthusiasm for telemental health in rural areas remains quite high, we lack a clear picture of the reality of telemental health in rural areas, compared to its promise. This Research & Policy Brief reports on the first part of our study—the online survey of 53 telemental health programs—and describes the organizational setting, services provided, and the staff mix of these programs. We draw from our telephone interviews with 23 of these programs to help describe the organizational context of telemental health programs. 

Key Findings:

  • The scope and volume of services provided are often modest suggesting that the business case for these programs may be weaker than the clinical case.
  • The programs in our study were able to secure funding and other supports to implement services, but their ability to maintain and expand services to address unmet need is less certain.
  • Telemental health primarily addresses issues related to the distribution of providers and travel distances to care. However, there are underlying practice management issues, common to all mental health practices in rural areas, which pose challenges to the scope and sustainability of telemental health, including reimbursement, provider recruitment and retention, practice economies of scale, high rates of uninsurance, and high patient “no show” rates.
  • It is becoming increasingly apparent that telehealth technology, by itself, cannot overcome service delivery challenges without underlying reform to the mental health service system.

Suggested Citation:

Lambert, D., Gale, J., Hansen, A. Y., Croll, Z., & Hartley, D. (2013). Telemental health in today's rural health system. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center.


Publication Type: 
Research and Policy Brief
Publish Date: 
December 18, 2013