Mental Health Now Accounts for 64% of All Telehealth in America

A clinical psychologist’s look at the data behind a structural shift — and what it actually means for the people not getting care.

In the first quarter of 2019, mental health conditions accounted for roughly one-third of all telehealth claim lines in the United States. By October 2025, that figure was 63.9%.

Telehealth in this country is no longer a general-purpose virtual care category that happens to include some mental health visits. Mental health is telehealth now — it dominates the modality, defines its growth curve, and explains why the numbers held steady after the pandemic surge faded for almost every other specialty.

I wanted to spend some time with what that data actually says, because the headline number — 64% — hides a more complicated picture about who is getting care, who isn’t, and why a structural shift this large has not closed the treatment gap the way most people assume it has.

The growth curve, in plain numbers

The trajectory is unusually clean for health policy data:

• Q1 2019: 32.4% of telehealth claims were mental health
• Q4 2022: 62.8%
• Q3 2023: 67.0%
• First half of 2024: 66.3% to 68.1%
• 2025: 58.5% to 63.9% (with a measurement methodology shift in January 2025)

Since 2019, telehealth mental health claims have grown by 5,123%. Total telehealth volume across all specialties plateaued after the pandemic peak. Mental health is what kept telehealth growing.

The infrastructure shift is just as dramatic. In 2019, only 39.4% of mental health and substance use disorder treatment facilities offered telehealth services. By 2023, that number was 88.1%. Seventy-three percent of US employers now offer virtual mental health benefits to their workforce. This is not a niche delivery model anymore.

Why mental health and not other specialties

The simple answer is that telehealth removed the barriers that disproportionately blocked mental health care: travel time, scheduling friction, the social cost of being seen walking into a therapist’s office, and the geographic concentration of specialized providers in dense urban markets.

The deeper answer is that traditional mental health infrastructure was already collapsing under demand pressure before 2020. As of late 2025, six in ten psychologists do not accept new patients. The average wait time for a behavioral health appointment exceeds 48 days in many markets. Approximately 122 million Americans live in federally designated Mental Health Professional Shortage Areas.

Telehealth didn’t create new demand. It revealed and partially absorbed demand that was always there but couldn’t reach a clinician within reasonable time and distance. When the only available appointment is six weeks out and 40 miles away, most people don’t go. When it’s available next Tuesday at 7 PM from your living room, more people go.

The therapeutic alliance translates

For a long time, the standard objection to telehealth therapy was that the therapeutic relationship — the alliance between clinician and client that decades of psychotherapy research has identified as the strongest predictor of treatment outcomes — couldn’t survive a screen.

The published research now says otherwise. Meta-analyses of cognitive behavioral therapy delivered via synchronous video for depression and anxiety have demonstrated non-inferiority to in-person treatment, with effect sizes for telehealth CBT depression reaching 0.84, which is considered a large effect.

The mechanism of change in psychotherapy is the relationship and the clinician’s competence, not the physical proximity. There’s also some evidence that telehealth may actually enhance engagement — patients are less likely to cancel a session that doesn’t require travel, and people often feel more grounded discussing difficult material from a familiar environment than from an unfamiliar office.

This isn’t a fringe finding anymore. It’s the consensus position of the literature.

The paradox: more access, same gap

Here is the part of the data that doesn’t make headlines but should.

Despite all of this expansion — the 5,123% growth, the 88% facility adoption, the 73% employer coverage — approximately 48% of the 62 million US adults with mental illness remain untreated.

Read that again. Half. After the largest expansion of mental health access infrastructure in American history.

The reason the gap hasn’t closed is that telehealth has, in some regions, widened disparities rather than narrowing them. STAT News reported in March 2026 on the emerging two-tier dynamic: affluent, broadband-connected, digitally literate populations have gained dramatic access to specialized remote care, while rural and economically marginalized populations remain in provider deserts. The HRSA Bureau of Health Workforce data confirms this pattern.

Telehealth, as currently structured, is a privatized fix to a public infrastructure problem. It works extraordinarily well for the populations who can pay for it and have the bandwidth to use it. It does not, on its own, reach the populations most underserved by traditional care.

Who is actually using telehealth mental health

The patient population shows a distinctive pattern. The growth has been concentrated in a few professional segments where telehealth solves specific problems traditional care doesn’t:

Executives and senior leaders use telehealth because they cannot be seen walking into a therapist’s office during business hours, and because their schedules don’t accommodate in-person care. Many specifically pay out-of-pocket to keep mental health treatment off any insurance trail their board or employer might encounter.

Healthcare professionals — physicians, psychiatrists, nurses — face professional liability concerns and licensing board scrutiny that make traditional care risky. Telehealth with private-pay providers who specialize in clinician burnout offers a path to treatment without an institutional record.

Attorneys have exceptionally high rates of depression, anxiety, and substance use disorders, and operate within a profession where bar character-and-fitness evaluations create legitimate fear of seeking documented mental health treatment. Telehealth specialists serving this population have grown rapidly.

Distributed and remote workers in the technology sector have embraced telehealth because in-person care is logistically incompatible with their work patterns. Younger cohorts in particular show lower stigma and higher comfort with virtual care.

What these populations have in common is privacy concern, schedule compression, and a need for clinicians who understand the specific psychological pressures of their roles. The market for these services has grown faster than the average.

The economic argument is unambiguous

The cost side of this story tends to get less attention than it deserves.

The annual cost of untreated mental illness in the United States exceeds $477 billion. The World Health Organization and International Labour Organization estimate that 12 billion working days are lost globally each year to depression and anxiety, translating to roughly $1 trillion in lost productivity. In the US, workers experiencing untreated mental illness perform at approximately 72% of their baseline capacity, and 50% of workers report having left a role due to mental health struggles.

The return on investment of mental health treatment is one of the more replicated findings in workplace health research: roughly four dollars in productivity gain and reduced absenteeism per dollar invested in treatment access.

For employers, telehealth mental health benefits are no longer a wellness amenity. They are a productivity intervention with a measurable financial return. The companies that haven’t moved in this direction are leaving money on the table in addition to leaving employees underserved.

What this means going forward

The data argues for a few specific structural moves, not all of which are happening at the pace they should.

Clinician training programs need to incorporate telehealth competency as standard curriculum, not as an elective specialization. Managing therapeutic alliance across a video connection, conducting crisis assessment in virtual settings, and understanding how technology shapes transference and countertransference are now core clinical skills.

Interstate licensure compacts need broader adoption. The current state-by-state patchwork constrains clinician capacity in exactly the regions where supply is most limited. Compact models work; expanding them is the highest-leverage policy move available.

Rural broadband investment is mental health infrastructure. Without it, telehealth’s expansion will continue to widen the disparity it has the technical capacity to close.

Employer benefit design should move beyond utilization metrics to outcome measurement. Telehealth access without specialty matching, schedule flexibility, and integration with primary care is less effective than it could be. The companies measuring this carefully are getting better results than the ones treating virtual mental health as a checkbox.

The bottom line

Telehealth mental health is not a temporary pandemic accommodation. It is the primary mechanism through which most Americans now access behavioral health care, and the trajectory is still upward.

The clinical evidence supports it. The economics support it. The patient preference data supports it.

What is still unresolved is whether this transformation will eventually reach the populations most in need of it, or whether it will remain — as it currently is — a powerful tool for the half of America that already has access, while the other half stays in the same provider deserts they’ve been in for thirty years.

That part isn’t a clinical question. It’s a policy question. And the data is increasingly clear that the answer matters.

This article is a synthesis of the CEREVITY whitepaper “2026 Telehealth and Mental Health: The New Standard,” with the full citation list and data tables available here.

Emily Carter, PhD is a licensed clinical psychologist at CEREVITY, a nationwide network of independent licensed clinicians offering private-pay concierge teletherapy for high-achieving professionals.