Kelli A., a client at Catholic Charities’ Villa Maria Behavioral Health Clinic in Frederick, calls telehealth “a godsend.”  When COVID-19 struck, she didn’t want to leave her house, but worried about missing appointments with her therapist and doctor.

“I have anxiety about going out,” Kelli said. “It’s due to PTSD. It would take a lot for me to go out and get in a cab or get on the bus.”

Since she began meeting her clinicians over Zoom, however, she hasn’t missed a single appointment – a far better attendance record than she had before the pandemic.

“Telehealth is an amazing tool, and … I would like to continue with it after COVID,” she said.

That’s a common refrain among many clients of Villa Maria clinics, said Emily Winicki, a therapist and supervisor at the Dundalk clinic.

“Telehealth worked out really well for people who had a lot of barriers – not just COVID, but transportation issues, health issues, mobility issues. With those barriers out of the way, if they have a smart phone, they [can participate],” Winicki explained. “The barriers I just talked about are still going to be here post-COVID. It’s really important that the platform continues for those hard-to-reach folks.”

Catholic Charities is advocating for legislation in the Maryland General Assembly that would expand telehealth coverage in public and private insurance to help address the skyrocketing need for mental health and substance use disorder care during the pandemic. The organization is currently delivering 3,500 telehealth visits per week to clients, including on its HIPAA-compliant Zoom platform. Passing these bills would significantly increase access to these vital services.

Overcoming barriers

Zoom and phone meetings will never replace in-person therapy – “laying eyes on people is important,” Winicki explained – and telehealth is not a good option for every Villa Maria client. Some don’t have a smartphone or can’t access technology. Others have concerns that they’ll be recorded, though that is illegal for mental health practitioners. Still others suffer from post-stroke cognitive impairments that make telehealth more challenging. But for many clients, virtual appointments have allowed treatment to continue at a time when it was badly needed, and they hope it remains an option.

Amanda S., a client at the Dundalk clinic, pointed to childcare as a significant challenge.

“I can’t come into [the] office due to pandemic and childcare issues,” she said. “My depression is very bad, and if I didn’t have telehealth, then my depression would not be treated. Even after the pandemic, I still will have childcare issues, and continuing to have telehealth would allow me to continue therapy.”

Another Dundalk client, Ann H., said she worries how she will make it to the clinic during bouts of intense physical pain. Multiple medical conditions and a fear of COVID-19 compound her challenges.

“Telehealth has allowed me to get my mental health treatment, while protecting my health at the same time,” she said. “After the pandemic is over, I’d like to come into [the] office some, but would still like the flexibility to continue to do telehealth.”

While many clients are eager to return to in-person visits when COVID restrictions ease, Winicki estimates between a quarter and a half of her clients will want to use telehealth at times.