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Delivering Mental Health Services in Person and Online

Adopting a “hybrid” approach to mental health services has allowed United Health Centers in Fresno, California, to greatly expand its outreach.

United Health Centers offers in-person counseling and telehealth options in some of central California’s most rural areas.  Director of Behavioral Health Sylvia Ramirez, a psychologist, said United currently offers on-site counseling at 13 of 28 sites and telehealth throughout its sprawling service area. Telehealth grew in popularity in recent years as some people wanted to avoid in-person visits for fear of COVID-19 exposure.  Additionally, the telehealth option helps to extend services to patients who lack transportation, are elderly, or just have trouble making the trip to a health center site because of work or family responsibilities.

United has been serving its community since 1971 but did not offer behavioral health services until 2014.  “It was challenging to start,” said Chief Executive Officer Justin Preas.

Dr. Ramirez, who provides psychotherapy in person and online in addition to overseeing the behavioral health program, said she has found that telehealth comes with various benefits and drawbacks.  Remote sessions make it harder to read a patient’s body language and can be particularly challenging when working with children.  However, telehealth has made it easier to provide services to patients in rural areas, including migrants and seasonal workers.  Telehealth also makes in easier to match Spanish language natives with Spanish speaking therapists in an area where about 39% of the 170,000 patients speak Spanish. “There has been a lot of benefits for the patients,” Ramirez said.