Blog · · 3 min read
More therapy now happens on a screen: a commentary
A new analysis finds that more Californians now get mental health care by video or phone than in person. What it shows, and what it leaves open.
Updated October 2026: figures have been checked against the original article and corrected, and sources added.
A Los Angeles Times article, republished on Yahoo News on 9 May 2025, reports a clear shift in how people in California receive mental health care. The piece, by Phillip Reese of KFF Health News, draws on an analysis of UCLA's California Health Interview Survey, which covers about 20,000 California households.
The findings are worth reading closely, because they describe a change that has outlasted the pandemic that started it.
What the figures show
According to the analysis, about 4.8 million California adults visited a medical professional for mental health or substance use care in 2023. Almost half of them did so exclusively by video or phone. About 24% used a mix of face-to-face and remote care, and roughly 23% were seen only in person.
Demand also grew over the period. The number of Californians seeing a professional for mental health issues rose by about 434,000, or 10%, between 2019 and 2023, and by nearly 2 million, or 69%, between 2009 and 2023.
Use of teletherapy was not even. About 81% of Bay Area residents who saw a professional for mental health care in 2023 did so fully or partly remotely, compared with about 62% in rural, mountainous counties. People living within 200% of the federal poverty level were less likely to use teletherapy.
The article also cites a separate national study of US Department of Veterans Affairs patients, in which 55% of mental health care continued to be provided by telemedicine. (An earlier version of this post wrongly attributed that figure to California as a whole.)
Is it as good as being in the room?
The article quotes Tao Lin, a researcher at the University of Pennsylvania's Center for the Treatment and Study of Anxiety, who has analysed studies comparing the two: "Research has basically shown that there's no difference between teletherapy versus in-person therapy." Joshua Heitzmann, president of the California Psychological Association, suggests comfort plays a part: "people are willing to work a little bit more when they're comfortable."
The same article notes the limits. Lin says it can be harder for a therapist to see hand movements or read body language on a video call, so nonverbal cues about a client's emotional state may be missed. His newer research, not yet published, suggests that phone therapy is less effective than video because more information is lost. And the income gap in who uses teletherapy is a reminder that remote care widens access for some people more than others.
These are reported findings and expert views in a news article, not a systematic review, and they describe one US state. They are a useful signal rather than a settled answer.
Where between-session information fits
Whether sessions happen in person, by video or by phone, the clinician sees a client for a small part of the week. When some of the cues available in a room are harder to read on screen, a little structured information from the days in between, such as a mood check-in or a short questionnaire completed with the client's agreement, can give the next conversation a starting point.
That information does not replace what a clinician notices in a session, and it should never be presented as if it could. At Myndgard we build Myndgard Share for university counselling services with that in mind: students already in counselling can share check-ins and questionnaire scores with their counsellor between sessions, with their consent, whatever form the sessions take.
In practice
For counselling services, the article's findings point to three practical questions. Which students are better served by remote sessions, and which by in-person ones? Who is being left out, for example by cost, connectivity or a lack of private space? And what does the counsellor need to know between sessions that they might otherwise have picked up in the room?
The answers will differ by service. The trend in the data suggests they are worth asking now.