Mental health visits up, suicidal behavior down for vets receiving iPads during pandemic, study finds

A program that put iPads in the hands of veterans with mental health issues early in the COVID-19 pandemic led to an increase in therapy sessions and a reduction in suicidal behavior, according to a new study.

At the start of the pandemic in 2020, the Department of Veterans Affairs distributed nearly 99,000 tablets to veterans for telehealth appointments, more than a third of which were issued to rural veterans without computers or who have had to travel long distances for medical treatment.

Among rural veterans receiving treatment for mental health issues, those with tablets participated in mental health appointments and psychotherapy visits at higher rates than those without the devices. , and they also had fewer emergency room visits and less suicidal behavior, a study published Wednesday in JAMA Network Open found.

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Suicide rates in the United States have risen disproportionately in rural counties over the past decade, with residents even more at risk during the pandemic when mental health providers were forced to shut down and relocate their online services.

The suicide rate for veterans is 1.5 times that of non-veterans, and vets in rural areas are more likely to die by suicide, according to data kept by the VA.

The department, which began distributing iPad tablets to veterans in 2016 through its offices of rural health and connected care, stepped up efforts early in the pandemic to ensure veterans could continue to access to treatment.

The investment seemed to pay off, according to the study conducted by VA Palo Alto researcher Kritee Gujral. The device-equipped group of vets saw a 36% drop in ER visits related to suicidal behavior, a 22% drop in the likelihood of suicidal behavior, and a 20% reduction in overall ER visits. emergencies, although the researchers noted that there were limitations to this data, given that COVID-19 has taken many away from hospitals.

Veterans also increased their attendance at therapy sessions, up nearly four visits per year, according to the study.

The encouraging results were also seen in veterans deemed at high risk for suicide by the VA, with even higher results in one measure – this group had access to nearly six additional therapy sessions per year, according to the ‘study.

Gujral wrote that although telehealth has had the potential to improve access to mental health care, little research has been done on its effectiveness on suicide prevention and outcomes.

“These results suggest that video tablets can provide access to essential services for rural patients with mental health needs and reduce instances of suicidal behavior and emergency department visits among them,” Gujral wrote.

During the COVID-19 pandemic, the VA has enhanced its telehealth capabilities for care across all departments and specialties. VA telehealth appointments and messages to providers jumped 3,147%, from 294,847 in fiscal year 2019 to 9,575,958 in fiscal year 2021.

For many veterans, telehealth provides accessible health care, and the VA plans to continue offering services remotely in the future, according to VA Secretary Denis McDonough.

“We want to keep it because it’s easy to access for vets who don’t need to be seen in person,” McDonough said during a hearing before a Senate Appropriations Committee on June 23, 2021.” It’s going to continue to need to be things that are done in person. … But I think as a system we recognize the huge efficiency gains and the huge satisfaction gains that come from vets spending less time to visit our facilities while receiving good care.

Veterans were eligible to receive a tablet with a data plan if they did not have theirs with connectivity via broadband or cell service and lived far from a VA medical facility or had data issues. transport.

Their doctors assured that they were able to physically and mentally operate the devices.

The researchers said their study had several limitations, noting that in general, veterans were given pills because they had been screened by the VA to facilitate health treatment and were already more likely to engage. in mental health services.

They added that future studies should look at the wider range of medical treatments the tablets can help treat, as well as program and usage costs.

But, they added, the results are encouraging.

“These results suggest that the VA and other health systems should consider using video tablets to improve access to mental health care via telehealth and to prevent suicides among rural residents,” they said. writing.

The Veterans Crisis Line can be reached 24/7 by calling 1-800-273-8255 and pressing 1, or by texting 838-255 or engaging via the Crisis Line website.

— Patricia Kime can be reached at Follow her on Twitter @patriciakime

Related: VA wants to waive some copays for vets at high risk of suicide

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