It has been a year like no other and that’s particularly true for the telemental health and telepsychiatry industries.

Unfortunately, mental health need has spiked during COVID-19, which has brought on the removal, at least temporarily, of nearly every barrier that previously limited telehealth.

While telehealth advocates have preached that telehealth is health, in 2020, we saw that come to fruition, particularly within the behavioral health space. You’d be hard pressed to find a behavioral health clinician today who has not held a remote session. So, what does this mean for the future?

As we look into the year to come, here are six trends we predict to see in 2021.

• Care for clinicians - Our health care workers, including mental health care clinicians are the heroes of the year, shouldering the burden, stress and pain of so many. This sacrifice comes at a cost. The burnout and fatigue clinicians are feeling are real and measurable. Employers are pouring resources into mental health support programs for their teams. In 2021, we predict these types of programs to finally become a permanent priority.  
• Crisis Intervention Teams expanding their reach by leveraging telehealth - As many communities have look closely at their police programs and funding in 2020, we anticipate a rise in crisis interventions teams or mobile crisis units that can bring trained mental health experts into the community to better respond to individuals in crisis. CITs, paramedic teams or even law enforcement can have more robust in-the-field support by leveraging remote behavioral health clinicians who can help assess risks and direct individuals to the appropriate level of care and support.  
• Collaborative Care - The connection between physical and mental health is indisputable, and payers across the country are doubling down on programs that help bring mental health care clinicians into individual’s primary care treatment teams. This is most efficiently done via telehealth. We anticipate major growth in this segment in 2021.  
• Treatment teams in crisis settings - As the strain on mental health care clinicians worsens, it is vital to make the highest and best use of all mental health resources. Accordingly, we are beginning to see modifications to crisis telepsychiatry programs that layer in different levels of remote behavioral health clinicians to help with screening, triage and care. This trend, paired with a newfound desire for behavioral health clinicians to work remotely (at least for part of their week), means we expect to see more and more remote telepsychiatry teams serving all settings of care.  
• Focus on disparities - 2020 put an important and needed lens atop healthcare disparities. We are seeing new telehealth organizations pop up that specialize in telemental health for populations with social, economic and/or environmental disadvantages and more focus placed on these efforts from existing telemental health players. One size does not fit all when it comes to mental health care, and determining the most effective ways to reach and appropriately address the needs of underserved populations must be a priority for all in 2021 and beyond. 
• Telehealth regulations WILL change permanently - 2020 was a regulatory sandbox for telehealth. Regulators moved incredibly quickly to greenlight any and every regulation that increased access to care via telehealth – however most of this year's changes were/are temporary and dependent on the public health emergency. As the CMS administrator, Seema Verma delivered what some consider the telehealth quote of the year: “The genie's out of the bottle on this one I think it's fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there's absolutely no going back." 

We are ready for permanent action. The telepsychiatry industry predicts and respectfully calls for regulators to make it happen. Here’s the short list:  

• Reimbursement - by CMS and by every private payer for all aspects of mental health care regardless of the modality, including audio-only encounters. It must happen and it must expand.  
• Simplified Licensure - In late November, a group of Congressmen introduced a bill (HR 8723) that would prevent states from receiving some forms of HHS funding unless they’ve joined the interstate medical licensure compact which makes it easier for physicians to use telehealth to treat patients across state lines. This bill showcases a sentiment we expect to follow us well into 2021. Unnecessary hoops to jump through in order to serve patients must go. 
• Appropriate Controlled Substance Prescribing via Telehealth - We must enact permanent policies to ensure access to behavioral health services via telehealth in order to address the opioid epidemic and other widespread behavioral health conditions. We call for the DEA to make a permanent and long-promised option for controlled substance prescribing via telemedicine under the Ryan Haight Act.

About the Author: Olivia Boyce, MPH is the chair of the American Telemedicine Association’s Telemental Health Special Interest Group and a Vice President at InSight + Regroup, the leading national telepsychiatry organization and a long time telehealth advocate.

About InSight + Regroup 

InSight + Regroup is the leading and largest telepsychiatry service provider in the US with a mission to transform access to quality behavioral health care.  InSight + Regroup serves hundreds of organizations and individuals in various settings across the continuum of care with its on-demand, scheduled services and Inpathy divisions.  Given its size, diversity of services and extensive experience and expertise, InSight + Regroup is uniquely positioned to enable scalable telepsychiatry programs across the care continuum.  As an industry thought leader, InSight + Regroup has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations.  To learn more, visit www.InSightTelepsychiatry.com and www.RegroupTelehealth.com.