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• Posted March 6, 2026

Telemedicine Not Closing the Mental Health Gap in Rural Areas

During the height of the COVID-19 pandemic, many health experts envisioned telemedicine as a "magic wand" that would bring mental health care to the most remote corners of the country. 

But a new study suggests that while the technology is now common, the digital divide for rural Americans remains as wide as ever.

Researchers analyzed Medicare billing records for more than 17,000 mental health specialists between 2018 and 2023 in all regions of the United States.

They looked at the share of their visits to patients living in rural, low-access-to-care or distant communities.

Their findings, published March 5 in JAMA Network Open, show that the massive shift to virtual care during the pandemic may have done little to help psychiatrists and therapists reach new patients in underserved areas.

The study found that specialists who used telemedicine the most saw only a tiny increase — less than one percentage point — in patients from rural regions compared to specialists who rarely used video calls. 

Interestingly, most of these long-distance visits weren't with new rural residents; instead, they were existing patients originally from the city who had moved away and kept their old doctors via the screen.

“We had thought the dramatic shift from in-person care to telemedicine among mental health specialists would lead to them caring for substantially more patients in rural communities,” study author Drew Wilcock said in a news release. He’s a lead research scientist at Brown University School of Public Health in Providence, Rhode Island.

“Unfortunately," he added, "We just don’t see it."

Perhaps the most surprising finding was that telemedicine might actually be making it harder for some people to find a doctor. 

Specialists who relied heavily on virtual visits saw their patient panel shrink, seeing 3.6% fewer new patients overall. 

This suggests that while video calls make it easier to maintain long-term relationships with current patients, it’s not opening up slots for anyone new.

The researchers argue that the problem isn't the technology, but the legal paperwork. Currently, a doctor in one state often cannot treat a patient in another without a separate, expensive license.

“Currently, it is too administratively burdensome for a mental health physician to get a license in many states,” explained lead author Dr. Jacob Jorem, a fellow at Harvard Medical School in Boston. 

Making it easier for clinicians to practice across state lines is a critical first step toward reaching rural patients, he suggested.

“The potential of telemedicine can’t be ignored,” said study author Dr. Ateev Mehrotra, a professor of health services, policy and practice at Brown. 

“But simply offering telemedicine will not address the barriers that many rural patients face in obtaining mental health care," Mehrotra said. "For telemedicine’s potential to be reached, we need policy interventions to address those barriers. Improving how we license physicians is a critical first step.”

More information

The Health Resources and Services Administration provides resources on telehealth programs and rural health initiatives.

SOURCES: Brown University news release, Mar. 5, 2026; JAMA Network Open, Mar. 5, 2026