Background: The use of telemental health via videoconferencing (TMH-V) became critical during the Coronavirus disease 2019 (COVID-19) pandemic due to restriction of non-urgent in-person appointments . The current brief report demonstrates the rapid growth in TMH-V appointments in the weeks following the pandemic declaration within the Department of Veterans Affairs (VA), the largest healthcare system in the United States .
Methods: COVID-19 changes in TMH-V appointments were captured during the six weeks following the World Health Organization's pandemic declaration (March 11 , 2020-April 22 , 2020). Pre-COVID-19 TMH-V encounters were assessed from October 1 , 2017 to March 10 , 2020 .
Results: Daily TMH-V encounters rose from 1,739 on March 11 to 11,406 on April 22 (556% growth , 222,349 total encounters). Between March 11-April 22 , 114,714 patients were seen via TMH-V, and 77.5% were first-time TMH-V users . 12,342 MH providers completed a TMH-V appointment between March 11-April 22, and 34.7% were first-time TMH-V users . The percentage growth of TMH-V appointments was higher than the rise in telephone appointments (442% growth); in-person appointments dropped by 81% during this time period . Discussion and
Conclusions: The speed of VA's growth in TMH-V appointments in the wake of the COVID-19 pandemic was facilitated by its pre-existing telehealth infrastructure, including earlier national efforts to increase the number of providers using TMH-V . Longstanding barriers to TMH-V implementation were lessened in the context of a pandemic, during which non-urgent in-person MH care was drastically reduced . Future work is necessary to understand the extent to which COVID-19 related changes in TMH-V use may permanently impact mental health care provision.