This article was first published in Christian Milaster’s Telehealth Tuesday newsletter and is re-posted here with permission.
Behavioral health remains one of the most pressing and underserved areas in healthcare — especially in rural and low-resource settings. CMS’s Rural Health Transformation (RHT) Program places strong emphasis on expanding access to behavioral health through integrated care models, digital tools, and value-based approaches. Telehealth behavioral health solutions continue to play a central role in closing access gaps and supporting clinicians who serve geographically isolated or understaffed communities.
In this article, we highlight 18 proven telehealth solutions that help organizations deliver timely, effective, and equitable behavioral health care. These approaches show how telehealth can strengthen the behavioral health continuum, from routine therapy and psychiatric care to crisis support and integrated primary care models.
CMS’s RHT Program places significant emphasis on expanding access to behavioral health through integrated care models, digital tools, and value-based payment arrangements. From digital therapeutics for substance use disorders to hub-and-spoke models that coordinate behavioral and physical health services, RHT recognizes telehealth as a key enabler of improved behavioral health outcomes in rural settings.
The 18 solutions below are organized into five strategic categories:
Synchronous Services: Live, scheduled telehealth visits delivered by licensed clinicians. Platform & Network-Based Models: Scalable delivery models using centralized or third-party resources. Digital Tools & Remote Monitoring: Technology-enabled support between visits to guide care and monitor risk. Integrated & Embedded Behavioral Health: Behavioral services woven into primary, specialty, and inpatient care. Crisis, Equity & Safety-Net Telehealth: Solutions designed to serve high-risk or underserved populations. Synchronous Clinical Services
These foundational telehealth services deliver real-time care from licensed clinicians, providing the most direct and widely adopted telehealth interventions for behavioral health needs.
1. TeleTherapy (Individual Counseling)
The most common use of telehealth by far is licensed therapists delivering one-on-one counseling sessions over video or phone.
Impact: Improves access, reduces stigma (due to increased privacy), and offers flexible scheduling for ongoing care.
2. TelePsychiatry for Medication Management
Psychiatrists provide diagnosis, medication initiation, and follow-up care virtually, extending psychiatric capacity across settings and expanding their geographic reach. Many of our rural clients are using virtual-only subcontracted Psychiatric NPs to provide access to psychiatric care.
Impact: Reduces wait times, supports medication adherence, and fills gaps in rural psychiatric coverage.
3. TeleGroup Therapy and TeleIOP
Group-based behavioral services, including intensive outpatient programs, are adapted for virtual delivery. Some of our clients offer hybrid TeleIOP, where clients can join remotely from home or the nearest clinic. Some of our clients are offering virtual-only, even immersive environments.
Impact: Expands capacity, supports peer-based models, and sustains engagement in structured care plans.
4. TeleCrisis Support in Emergency Departments
Remote psychiatric consults support ED teams in real time during behavioral health crises. Used by almost all of our clients.
Impact: Improves timely access, reduces windshield time or driving in inclement weather or at night. Reduces ED boarding times and enhances triage, especially in facilities without on-site psychiatric services.
5. TeleBehavioral Health at the Inpatient Bedside
Hospitals connect patients with remote behavioral specialists during their stay to improve clinical care management. This initial contact can establish a relationship that continues after discharge.
Impact: Ensures timely psychiatric and psychological care, supports discharge planning, increases client engagement in their care plan, and improves whole-person care.
Platform & Network-Based Models
These scalable approaches use third-party networks or centralized hubs to expand behavioral health capacity across multiple sites or regions.
6. Outsourced TelePsychiatry Networks
Similar to #2 above, organizations contract with virtual psychiatry vendors to provide consults and follow-up care.
Impact: Addresses psychiatrist shortages and enables rapid coverage across multiple sites.
7. Virtual-Only TeleTherapy Providers
These are the consumer-facing platforms that offer remote therapy, independent of local health systems, for a fixed monthly fee with 24/7 chat access to a therapist and, typically, weekly video sessions.
Impact: Increases access to care, but may not be affordable for some and may pose challenges to care continuity, especially without integration into primary care.
8. Hub-and-Spoke Behavioral Health Models
Centralized clinical teams provide virtual consults and support to rural or remote clinics.
Impact: Scales behavioral care while maintaining quality across multiple rural locations
Now we are getting into the realm of more “fancier” technologies — digital therapeutics, mobile apps, and monitoring tools extend behavioral health care between visits, enabling continuous engagement, proactive outreach, and data-informed interventions.
9. Digital Therapeutics for Mental Health and SUDs
FDA-cleared apps deliver CBT-based or condition-specific behavioral interventions.
Impact: Augments therapy and fills gaps when clinicians or in-person care aren’t available.
10. Remote Physiological Monitoring (RPM) for Behavioral Health
Wearables, mobile apps, and connected devices that track sleep, physical activity, and physiological indicators such as heart rate variability can offer valuable behavioral insights between visits.
Impact: Enhances care continuity, supports early intervention, and supplies clinicians with objective, real-time behavioral data.
11. AI Chatbots and Digital Companions
Automated agents guide patients through structured check-ins or therapeutic content.
Impact: Enhances patient engagement and reduces isolation between clinical sessions.
12. Asynchronous Messaging and Check-Ins
Most of us use a form of texting to communicate with friends and family. The success of platforms such as those mentioned under #7 above proves that this is a preferred modality for patients: Secure communication platforms that support brief clinician-patient communication between visits.
Impact: Reinforces care plans, prevents drop-off, and supports flexible outreach.
Integrated & Embedded Behavioral Health
These solutions embed behavioral health directly into medical care environments, creating coordinated, team-based approaches to treat the whole person.
13. TeleBehavioral Health in Primary Care
Virtual consults support primary care teams via collaborative care models.
Impact: Improves screening, treatment adherence, and whole-person outcomes.
14. Behavioral Health Integration in Specialty Clinics
Oncology, cardiology, and other clinics incorporate virtual behavioral consultations to support patients in managing their diagnosis or chronic disease, enabling them to actively participate in their care plan.
Impact: Addresses psychosocial needs and improves chronic disease management.
15. Consultation-Liaison TelePsychiatry in Hospitals
Medical teams collaborate with remote psychiatric providers during hospitalization.
Impact: Manages co-occurring conditions, supports discharge, and reduces readmissions.
16. Behavioral Telehealth in Nontraditional Settings
Telehealth brings care to schools, correctional facilities, and workplaces.
Impact: Extends behavioral services to underserved populations where care is rarely available.
Crisis, Equity & Safety-Net Telehealth
Focused on high-risk and underserved populations, these models use telehealth to close critical gaps in behavioral health access and responsiveness.
17. Mobile Crisis Teams with Telehealth Backup
Field-based crisis responders access virtual psychiatric support in real time.
Impact: Strengthens crisis response in rural areas and improves assessment accuracy.
18. 24/7 Hotlines with TeleFollow-Up
Behavioral health hotlines are paired with scheduled virtual visits after a crisis.
Impact: Improves continuity, reduces repeat ED visits, and supports recovery.
Conclusion: Behavioral Health Needs Strategy, Not Just Technology
Telehealth behavioral health solutions have become essential tools for expanding access, strengthening care coordination, and improving outcomes—particularly in rural and underserved communities. The 18 approaches highlighted above show how clinicians can combine telepsychiatry, virtual therapy, digital behavioral health tools, remote monitoring, and crisis telehealth models to deliver more responsive, patient-centered care.
As CMS continues prioritizing integrated, technology-enabled behavioral health under programs like the Rural Health Transformation initiative, now is the time for clinicians and health systems to evaluate which telehealth behavioral health solutions can best support their teams and communities. Assessing organizational needs, optimizing workflows, and adopting evidence-based virtual care strategies can help expand access to rural behavioral health services and prepare practices for future payment and delivery reforms.
Christian is the Director of Consulting at Telehealth.org. To schedule a free consultation about this article or other topics, submit a request here.
If you are considering ways to strengthen your behavioral health services or implement new telehealth capabilities, we welcome the opportunity to discuss how these solutions can fit into your broader care strategy.