HJNO Mar/Apr 2022

52 MAR / APR 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN MENTAL HEALTH THERE are many reasons why behavior- al health patients, their clinicians, health systems, and insurers support virtual care and believe it to be as good as, or better than, in-person appointments. Virtual mental health care involves conducting mental health treatment, such as therapy and psychiatric medication management appointments via a secure, online plat- form. Offering both in-person and virtual care, also known as a hybrid model, has become the expectation. The strong, positive belief in the qual- ity of virtual appointments is, however, based almost exclusively on accessibility and convenience. One of the most im- portant characteristics of virtual care has been its ability to easily expand access to care, but it is necessary and reasonable to ask, “What do we know about the overall quality and effectiveness of virtual mental healthcare?” Tomeasure quality, youmust first estab- lish an objective definition with an agreed upon set of measurable standards. In men- tal health research, we typically measure quality of treatment by a change in symp- tom severity, quality of life, and functional outcomes, but quality standards need to be further developed for telepsychiatry and teletherapy. The U.S. Department of Health and Hu- man Services (HHS) requested the Nation- al Quality Forum (NQF) to convene an ex- pert committee to develop a measurement framework and a conceptual foundation for newmeasures, where needed, to assess the quality of care provided using tele- health modalities. The NQF identified four quality domains for overall telehealth that included virtual mental healthcare. Their four domains are listed below: 1. The access to care domain focuses on the patient’s ability to connect to care and the affordability, availability, and accessibility to a specialist in a timely manner. 2. The financial impact domain consid- ers the cost of telehealth services to the patient, care team, health system, and payer. It also looks at the cost as- In-Person or Virtual Mental Healthcare: What’s Best?