Provider and leadership attitudes toward telemental health at sites with high levels of video, phone, and in-person care: A qualitative analysis.

This study examined mental health (MH) provider and leadership attitudes toward the use of video, phone, and in-person MH care within the U.S. Department of Veterans Affairs. Twenty-four semistructured qualitative interviews were conducted at six Department of Veterans Affairs medical centers between January and June 2024 (two high video use sites, two high phone sites, and two high in-person sites). Four interviews were conducted per site (three MH providers and one member of MH leadership). Interviews underwent rapid qualitative analysis informed by the Integrated-Promoting Action on Research Implementation in Health Services framework. Attitudes toward video care were largely positive across respondents and sites, and most respondents felt the quality of video care was comparable to in-person. Beliefs about phone care varied substantially, with some citing the loss of important nonverbal information as a major deterrent to use, while others noted phone's benefits in increasing access to care for vulnerable veterans. High video sites tended toward more negative views of phone care as opposed to the high phone and in-person sites. Site-level guidance varied regarding the permissibility of phone care. Findings describe a unique postpandemic period in care modality decision making in which there is an unprecedented amount of choice and variability in how MH services are delivered. It will be important to equip providers, patients, and leadership with comprehensive information regarding the relative benefits and drawbacks of each modality, as well as resources that can improve access to care, to help inform decision making and ensure provision of high-quality MH services. (PsycInfo Database Record (c) 2026 APA, all rights reserved).