This document discusses the use of telehealth for mental health services in Minnesota before and during the COVID-19 pandemic. It finds that the percentage of mental health providers offering telehealth consultations increased dramatically during the pandemic. It also finds that most providers plan to continue offering some telehealth services after the pandemic ends. Finally, it discusses some of the benefits of telehealth, such as increased access in rural areas, as well as challenges like inadequate infrastructure and lack of private spaces for clients.

1. P R O T E C T I N G , M A I N T A I N I N G A N D I M P R O V I N G T H E H E A L T H O F A L L M I N N E S O T A N S
Teri Fritsma, Ph.D.
Lead Healthcare Workforce Analyst, MDH
July 21, 2020
COVID, Mental Health Services, and Telehealth

2. MDH’s Health Workforce Analysis Unit
Health Policy Division > Office of Rural Health & Primary Care
• Through state law, we survey and study the licensed healthcare workforce in Minnesota,
including mental health providers.
• This work informs: state legislation, professional associations, post-secondary
institutions, licensing boards, work groups, other research, and media.
• Currently, we have a COVID-specific version of our survey in the field.
About my workgroup

3. We know there’s a serious maldistribution of mental health
providers across Minnesota.
With no action, it will worsen.

4. Location of practice
Mental health
professionals
Data sources: MDH analysis of 2019 address data from the Board of Social Work; the
Board of Marriage and Family Therapy; the Board of Psychology; and the Board of
Behavioral Therapy. Note: not every dot represents one provider. When two or more
providers work at a single address, the dots overlap. We can regard each dot as a location
where at least one provider is working.

5. Location of practice
Licensed Alcohol
and Drug
Counselors
Data sources: MDH analysis of 2019 address data the Board of Behavioral Therapy.
Note: not every dot represents one provider. When two or more providers work at a
single address, the dots overlap. We can regard each dot as a location where at least
one provider is working.

6. Location of practice
Prescribers
Psychiatrists and
Psychiatric APRNs
Data sources: MDH analysis of 2019 address data from the Board of Medical Practice and
the Board of Nursing. Note: not every dot represents one provider. When two or more
providers work at a single address, the dots overlap. We can regard each dot as a location
where at least one provider is working.

7. Share of providers who say they plan to leave their profession
within five years
in metro versus small town/rural areas
17%
19%
8%
10%
4%
13%
33%
49%
14%
6%
14%
Psychiatrists Psychiatric
APRNS
Psychologists LMFTs LPCCs LICSWs
Metropolitan areas
Small town and rural areas
NA
Data source: MDH Healthcare Workforce Survey for each profession.
MH Prescribers MH Professionals

8. Telemedicine is often considered a possible partial
solution to the maldistribution problem.
How has COVID-19 affected the use of telemedicine
among Minnesota’s mental health providers?
The short story:
COVID-19 has created a shock to the system that could change
mental health service delivery for good.

9. Share of mental health providers who consult with patients via telemedicine,
before and during COVID
Data source: MDH healthcare workforce survey. (Current survey N=1,286)
*Includes both Licensed Professional Counselors and Licensed Professional Clinical Counselors
32% 32%
23% 22% 20% 20%
17%
78%
54% 56%
Psychiatric
APRNs
Psychiatrists Licensed
Professional
Counselors*
Alcohol & Drug
Counselors
Marriage &
Family Therapists
Social Workers Psychologists
Pre-COVID (Calendar year 2019)
During COVID (May-June 2020)
NA NA NA NA

10. “Approximately how much of the care you provided was via a dedicated
telemedicine platform?”
Data source: MDH healthcare workforce survey.
*Includes both Licensed Professional Counselors and Licensed Professional Clinical Counselors
72%
63%
65%
12%
13%
13%
16%
24%
22%
Licensed Professional Counselors*
Alcohol & Drug Counselors
Social Workers
75-100% 50-75% Less than 50%

11. Share of providers who say they plan to continue providing
at least some services via telemedicine post-COVID:
Data source: MDH healthcare workforce survey.
*Includes both Licensed Professional Counselors and Licensed Professional Clinical Counselors
Alcohol & Drug Counselors: 75%
Licensed Professional Counselors*: 87%
Social Workers: 78%

12. “Please share any comments about the ways in which telemedicine works or
doesn’t work in caring for patients or clients.”
• “I work in mental health and I think it works well. We have fewer no-shows, and clients generally like it. A lot of people are
uncomfortable coming in to the office even without a pandemic.”
• “Great for many, especially in Minnesota winters!”
• “Telemedicine works well for me for people who struggle with transportation issues in rural areas.”
• “It works in the sense that I can still provide much-needed client care. But it doesn’t work in the sense that there’s inequality in
clients being to access telemedicine.”
• “Some clients do not feel that they have a safe, secure space to speak openly and that has been challenging. Bad internet
connections also impact the experience.”
• “Poor bandwidth in rural areas.”
• “Infrastructure is inadequate. Technology to facilitate it is either outdated, not present, or staff have not received proper training
to use it effectively. Bad connection and spotty sound/picture also remain problems. Good idea, but not well executed.”
• “Telemedicine has been integral in providing services to vulnerable and oppressed populations that face transportation issues,
scheduling concerns, unforgiving work schedules, family demands, and poor organization due to a variety of factors. It behooves us
as social workers to fight for this service to remain a widely-available platform for services that have typically been gatekept for
those with flexible business hours, reliable transportation, and available childcare.”

13. How can MDH/ORHPC be a resource to you?

14. W W W . H E A L T H . M N . G O V
Thank you!
Teri.Fritsma@state.mn.us
651-201-4004