Availability and Accessibility of Mental Health Services in New York City.

Mental health services are critical components of public health infrastructure that provide essential supports to people living with psychiatric disorders. In a typical year, about 20 percent of people will have a psychiatric disorder, and about 5 percent will experience serious psychological distress, indicating a potentially serious mental illness. Nationally, the use of mental health services is low, and the use of care is not equitably distributed. In the United States as a whole and in New York City (NYC), non-Hispanic white individuals are more likely to use mental health services than non-Hispanic black individuals or Hispanic individuals. The challenges of ensuring the availability of mental health services for all groups in NYC are particularly acute, given the size of the population and its diversity in income, culture, ethnicity, and language. Adding to these underlying challenges, the coronavirus disease 2019 (COVID-19) pandemic has disrupted established patterns of care. To advance policy strategy for addressing gaps in the mental health services system, RAND researchers investigate the availability and accessibility of mental health services in NYC. The RAND team used two complementary approaches to address these issues. First, the team conducted interviews with a broad group of professionals and patients in the mental health system to identify barriers to care and potential strategies for improving access and availability. Second, the team investigated geographic variations in the availability of mental health services by compiling and mapping data on the locations and service characteristics of mental health treatment facilities in NYC.

Telehealth Adoption by Mental Health and Substance Use Disorder Treatment Facilities in the COVID-19 Pandemic.

OBJECTIVE: The study examined temporal and geographic trends in telehealth availability at U.S. behavioral health treatment facilities and risk factors for not offering telehealth. METHODS: Longitudinal data on 15,691 outpatient behavioral health treatment facilities were extracted daily from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Services Locator between January 20, 2020, and January 20, 2021. Facilities operated by the Department of Veterans Affairs were excluded. Bivariate analyses were used to assess trends in telehealth availability in 2020 and 2021. Multivariable regression analysis was used to examine facility- and county-level characteristics associated with telehealth availability in 2021. RESULTS: Telehealth availability increased by 77% from 2020 to 2021 for mental health treatment facilities and by 143% for substance use disorder treatment facilities. By January 2021, 68% of outpatient mental health facilities and 57% of substance use disorder treatment facilities in the sample were offering telehealth. Mental health and substance use disorder treatment facilities that did not accept Medicaid as a form of payment were less likely to offer telehealth in 2021, compared with facilities that accepted Medicaid. Mental health and substance use disorder treatment facilities that accepted private insurance were more likely to offer telehealth in 2021, compared with facilities that did not accept private insurance. CONCLUSIONS: Although 2020 saw a dramatic increase in telehealth availability at behavioral health treatment facilities, 32% of mental health treatment facilities and 43% of substance use disorder treatment facilities did not offer telehealth in January 2021, nearly 1 year into the pandemic.

COVID-19 Air Traffic Visualization: By January 31, 2020, at Least 1.5 Daily Infected Passengers Were Originating in China

The COVID-19 Air Traffic Visualization (CAT-V) tool combines COVID-19 case data from Johns Hopkins University and International Air Transport Association air travel data to examine COVID-19 virus transmission as a result of commercial air travel. Using the CAT-V tool, the authors estimate the rate of COVID-19 transmission through commercial air travel from China. By January 31, 2020 there were at least 1.5 infected air travel passengers coming from China each day. Eight countries were identified with the highest risk of COVID-19 infection from China air travel on January 24, 2020: Japan, Thailand, South Korea, United States, Taiwan, Australia, Singapore, and Malaysia. As of January 31, 2020, these eight countries had the most confirmed COVID-19 cases outside of China.

COVID-19 Air Traffic Visualization: COVID-19 Cases in China Were Likely 37 Times Higher Than Reported in January 2020

The COVID-19 Air Traffic Visualization (CAT-V) tool combines COVID-19 case data from Johns Hopkins University and International Air Transport Association air travel data to examine COVID-19 virus transmission as a result of commercial air travel. In this report, COVID-19 case reports from China are examined along with detailed flight data. Using the CAT-V tool the authors determined that the five countries most at risk of COVID-19 transmission from China were: Japan, Thailand, South Korea, United States, and Taiwan. Based on the number of passengers who flew from China to these five countries during December 31, 2019 to January 22, 2020 and China's reported case rate, it is calculated that the expected COVID-19 exportation rate would be less than one case in all five countries combined. However, since all five countries had reported COVID-19 cases by January 22, 2020, it is estimated that the actual case rate in China would need to be approximately 37 times higher than reported (18,700 cases versus 503 cases reported on January 22, 2020) to reach the odds of a COVID-19 case appearing in each country.

COVID-19 Air Traffic Visualization: Decisionmakers Should Base Travel Restrictions on Infection Rates Per Capita and Air Traffic Levels

The COVID-19 Air Traffic Visualization (CAT-V) tool combines COVID-19 case data from Johns Hopkins University and International Air Transport Association air travel data to examine COVID-19 virus transmission as a result of commercial air travel. Using the CAT-V tool, the authors find that even countries with a modest number of confirmed COVID-19 cases can be a great risk to the U.S. The authors suggest that travel advisories should be based on reducing passenger travel from countries with both high infection rates and high levels of passenger travel to the U.S.

COVID-19 Air Traffic Visualization: A New Tool Helps Analyze Commercial Air Travel Involving Infected Passengers

The COVID-19 Air Traffic Visualization (CAT-V) tool combines COVID-19 case data from Johns Hopkins University and International Air Transport Association air travel data to examine COVID-19 virus transmission as a result of commercial air travel. CAT-V can be used to forecast COVID-19 patterns of transmission using air travel data and reported infection rates. The authors use case rates and number of air passengers originating from each country and passenger destinations to identify the eight countries with the highest risk of importing COVID-19 from China on January 24, 2020. The tool can also be used to examine the risks of individual air travel routes. Future versions of the CAT-V tool will include province and state-level data.

COVID-19 Air Traffic Visualization: Air Passenger Transmission Risk to GCC Countries Originated from Outside the Region

The COVID-19 Air Traffic Visualization (CAT-V) tool combines COVID-19 case data from Johns Hopkins University and International Air Transport Association air travel data to examine COVID-19 virus transmission as a result of commercial air travel. In this report the authors use the CAT-V tool to examine COVID-19 transmission risk from air travel to the United Arab Emirates (UAE) and other Gulf Cooperation Council countries. It is determined that on January 28, 2020 the majority of COVID-19 transmission risk from air travel came from passengers from China;by February 29, 2020, the greatest source of potentially infected air travelers to the UAE was South Korea, followed by Italy and China.