• Jacqueline B Britz, Alison N Huffstetler, Tracey L Henry, Braveen Ragunanthan, Erin Britton, Neeti Doshi, Kurt C Stange, and Rebecca S Etz.
• From Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, RSE); Department of Medicine, General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA (TLH); Delta Health Center, Mound Bayou, MS (BR); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond VA (EB); Department of Pediatrics, University of California, San Francisco (ND); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KCS); The Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Richmond, VA (RSE). jacqueline.britz@vcuhealth.org.
• J Am Board Fam Med. 2022 Oct 18; 35 (5): 891-896.

BackgroundThe COVID-19 pandemic resulted in a worsening mental health crisis, while also dramatically reducing access to in-person primary care services. Primary care, an essential provider of mental health services, rapidly adopted telemedicine to address behavioral health needs. Here we examine the provision of mental health services by primary care during the pandemic, including the essential use of telemedicine. METHODS: Data were collected via a series of national, cross-sectional surveys of primary care clinicians in November 2020 by the Larry A. Green Center. The survey was distributed through a network of partner organizations and subscribers. Descriptive and chi squared analysis were utilized. RESULTS: Among 1,472 respondents, 88% reported increased mental health needs and 37% reported higher rates of substance use among patients. Most (65%) clinicians became more involved in providing mental health support, and 64% reported using telemedicine to provide behavioral health services. Phone-based care was more common for care delivery among patients who were uninsured (60% vs 42%, P < .01), Medicare beneficiaries (45% vs 36%, P < .05), non-English speaking (67% vs 40%, P < .001), and racial and ethnic minorities (58% vs 34%, P < .001). CONCLUSIONS: Primary care is a leading provider of mental health services and has played a critical role during the pandemic. Primary care clinicians have strong relationships with their patients as well as outreach within communities that may otherwise struggle to access mental health services. The use of telemedicine in primary care, and specifically phone-based services, has been an essential tool to providing equitable access to mental health services.© Copyright by the American Board of Family Medicine.

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