Offline Privacy Concerns in Mental Health Care Delivery Through Telehealth

Mental health conditions are responsible for 23% of all pregnancy-related deaths in the US. A

significant contributor is postpartum (after birth) mental health issues, primarily depression,

which affect 1 in 8 mothers. Yet more than half of new mothers with depression go untreated.

Telehealth has the potential to increase access to and utilization of mental health care, but any

such benefits may be affected by offline privacy concerns. On the one hand, consumption of

telehealth services may be less observable, alleviating concerns about societal stigma related

to the use of mental health services (“privacy in the community”). On the other hand, telehealth

shifts care from a provider office setting to a home setting, which may reduce privacy

for individuals in crowded households (“privacy at home”). Using detailed insurance claims

data surrounding a period of rapid increase in telehealth use, we find that telehealth availability

increases treatment utilization, with higher utilization where there is a high societal stigma to

the use of mental services and lower utilization for individuals in crowded households. These

insights are potentially actionable as insurers and providers can expand the utilization of maternal

mental health services by increasing support for telehealth in environments where there

is high societal stigma, and seek alternative delivery mechanisms for individuals who may live

in crowded households. Furthermore, our findings are likely to extend beyond maternal mental

health setting, as the advantages and disadvantages of telehealth and the associated privacy

concerns are not exclusive to mothers or mental health.