Telehealth Services and Mental Health Outcomes: The Mediating Role of Therapeutic Accessibility

Abstract

The rapid expansion of digital healthcare has transformed the delivery of mental health services by enabling patients to access psychological and psychiatric support through video consultations, telephone services, mobile applications, online counseling, and other remote communication technologies. Telehealth has become particularly relevant to mental healthcare because geographical distance, transportation difficulties, provider shortages, stigma, cost, and limited availability of specialized professionals can prevent individuals from obtaining timely treatment. Although telehealth services can substantially increase the availability and convenience of mental healthcare, access to a digital service does not necessarily guarantee improved mental health outcomes. Therapeutic accessibility may represent an important mechanism through which telehealth contributes to better psychological well being. This study examines the relationship between telehealth services and mental health outcomes and investigates the mediating role of therapeutic accessibility. The proposed framework integrates the Technology Acceptance Model, Andersen's Behavioral Model of Health Services Use, and the accessibility perspective in healthcare. Telehealth services represent the independent variable, therapeutic accessibility represents the mediating variable, and mental health outcomes represent the dependent variable. A quantitative cross sectional research design is proposed, targeting adults who have used telehealth services for mental health related support. Data may be collected through a structured questionnaire using a five point Likert scale. Partial Least Squares Structural Equation Modeling through SmartPLS can be employed to examine the measurement and structural models. The proposed framework evaluates the direct relationship between telehealth services and mental health outcomes, the relationship between telehealth services and therapeutic accessibility, the effect of accessibility on mental health outcomes, and the indirect effect of telehealth through accessibility. Illustrative results indicate that telehealth services positively influence therapeutic accessibility and mental health outcomes, while therapeutic accessibility also positively influences mental health outcomes. Mediation analysis indicates that therapeutic accessibility partially mediates the relationship between telehealth services and mental health outcomes. The findings suggest that the effectiveness of telehealth should not be assessed solely in terms of technological availability. Rather, meaningful access requires convenient scheduling, affordable services, continuity of care, suitable communication channels, qualified professionals, privacy, and timely therapeutic interaction. Healthcare providers should therefore design telehealth systems around patient accessibility and continuity. The study contributes to digital health and mental healthcare research by identifying therapeutic accessibility as a key mechanism through which telehealth services can potentially improve mental health outcomes.