Examining the state of telehealth for mental health and substance use care after the coronavirus disease 2019 pandemic: An integrative review.

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not reported — no quantitative pooling performed; findings are narrative and thematic

• Primary Outcome: Four thematic domains identified: (1) treatment adherence — telehealth supported continuity of care; (2) patient and provider satisfaction — generally improved with telehealth; (3) telehealth policy developments — broader adoption enabled by regulatory changes, though jurisdictional variation noted; (4) access to services — improved overall, but technological and financial barriers restricted equitable access for vulnerable populations

• Nnt Or Sensitivity: Not reported — no NNT, sensitivity/specificity, or hazard ratio data available from this integrative review design

• Confidence Interval: Not applicable — no meta-analytic synthesis conducted

Clinical Application

Telehealth delivery of mental health and SUD care is broadly feasible in adequately resourced settings with digital infrastructure. Key implementation barriers identified include patient-level digital literacy and device access, financial constraints (particularly for low-income and rural populations), and provider-level regulatory and reimbursement variability. Feasibility is contingent on sustained policy support and equitable technology access. In Australia, telehealth for mental health is supported under Medicare Benefits Schedule (MBS) items introduced and expanded during the COVID-19 pandemic, with ongoing provisions for video and telephone consultations for psychiatry, psychology, and general practice mental health care. The RACGP supports telehealth as a complement to in-person care, particularly for rural and remote populations. The Therapeutic Goods Administration (TGA) regulates digital health tools and prescription medications delivered via telehealth, including Schedule 8 substances relevant to opioid agonist therapy (OAT) for SUD. PBS-subsidised medications (e.g., buprenorphine, naltrexone) can be initiated and managed via telehealth in many jurisdictions, subject to state-based controlled drug regulations. The findings of this review regarding jurisdictional policy variability are directly relevant to the Australian context, where telehealth prescribing rules for controlled substances differ between states and territories. The National Mental Health and Suicide Prevention Plan and the Australian Digital Health Agency's national strategy both support expanded telehealth integration, making this review's themes of access, equity, and policy coherence particularly pertinent. Adults with serious mental illness (including schizophrenia spectrum disorders, bipolar disorder, major depressive disorder) and substance use disorders receiving outpatient or community-based mental health services. Applicability to inpatient, forensic, or paediatric populations is not established by this review.

Abstract

ObjectiveThe objective of this integrative review was to synthesize literature and provide implications for clinical practice on telehealth use among patients with serious mental illness and substance use disorders following the coronavirus disease 2019 pandemic.MethodsAn integrative review guided by Socio-Technical Systems Theory was applied. The PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Medline, Academic Search Complete, and Gale Health and Wellness databases were searched for publications from 1 January 2019 to 1 December 2024. Articles selected according to the established inclusion and exclusion criteria were evaluated using a rapid critical appraisal checklist developed by Fineout-Overholt and Melnyk.ResultsAmong the 172 articles reviewed, 16 peer-reviewed and 2 government publications were included. Four themes were identified: (a) treatment adherence; (b) satisfaction reported by patients and providers; (c) telehealth policy developments; and (d) access to services. Telehealth supported continuity of care, improved satisfaction, and improved access. Technological and financial barriers restricted equitable access. Policy changes enabled broader adoption; however, regulatory approaches varied across jurisdictions.ConclusionTelehealth remains an integral method for delivering mental health and substance use care following the coronavirus disease 2019 pandemic. Greater focus is needed on long-term effectiveness and limitations of telehealth.

References

1. 1.Smith-East, M. (2026). Examining the state of telehealth for mental health and substance use care after the coronavirus disease 2019 pandemic: An integrative review. The Journal of International Medical Research. Advance online publication. https://doi.org/10.1177/03000605261459841