Telehealth and Hybrid Service Use for Major Depression and Substance Use Disorders Among U.S. Adults, 2022-2023.

INTRODUCTION

This study examined patterns of telehealth and hybrid service use (telehealth combined with outpatient or inpatient care) for major depressive episodes and substance use disorders among U.S. adults.

METHODS

Pooled data from the 2022 and 2023 National Survey on Drug Use and Health (N=92,233) were analyzed to examine trends and patterns in overall telehealth use and hybrid service use among adults with past-year major depressive episodes and those with past-year substance use disorders. Bivariate analyses and survey-weighted multivariable logistic regression were conducted between December 2024 and May 2025.

RESULTS

Among adults with past-year major depressive episodes, telehealth use remained stable at around 44% from 2022 to 2023, whereas outpatient care remained the most common treatment modality and increased from 46.1% to 50.0% (OR=1.16, p<0.05). Among adults with past-year substance use disorders, telehealth use increased nonsignificantly from 5.4% in 2022 to 6.2% in 2023. For major depressive episodes, telehealth use was higher among females than among males (AOR=1.41, p<0.001) and among those with Medicaid (AOR=1.90, p<0.001) or private insurance (AOR=1.79, p<0.001) than among uninsured adults. Adults with major depressive episode-related severe impairment were more likely to use telehealth overall (AOR=1.55, p<0.001) and hybrid care. For substance use disorders, adults living in small metropolitan areas had lower telehealth use than those in large metropolitan areas (AOR=0.77, p<0.05). Telehealth use was also higher among those with moderate (AOR=2.72, p<0.001) or severe (AOR=10.04, p<0.001) substance use disorders than those with mild substance use disorders.

CONCLUSIONS

Telehealth and hybrid service use for major depressive episodes and substance use disorders remained largely stable in the postpandemic period. When integrated with in-person care, telehealth can help expand access to mental health and substance use treatment among U.S. adults.