Using Telehealth for Mental Health

Madison County in Texas is considered both a mental health and primary care Health Professional Shortage Area (HPSA). The county found that about 20 percent of the residents surveyed have been diagnosed with mental issues such as depression and/or anxiety.

In 2011, Texas A&M’s Center for Community Health Development was able to identify local organizations that could start mental health and substance abuse prevention and treatment services for people in the County.

The result is that the “Madison Outreach Services through Telehealth” (MOST) Network was established by receiving support from HRSA’s Federal Office of Rural Health Policy through a Rural Health Care Services Outreach grant.

The primary focus for MOST is to link behavioral and mental healthcare service in urban communities to rural residents. To do this, the MOST Network replicated a neighboring community’s model and brought it to Madison County. In order to better serve the Latino community, the Network trained Community Health Workers (CHW) and was able to introduce Spanish-speaking residents to health and social services.

Under supervision, doctoral-level psychology students from Texas A&M provide counseling services in both English and Spanish from the Telehealth Counseling Clinic (TCC) to rural clinics using videos or by phone.

By using the MOST Network, it was found that telehealth-based counseling avoided obstacles to counseling such as clients experiencing physical disabilities, social anxiety, geographic isolation, plus financial and time constraints.

However, there were problems in providing the service such as:

  • Establishing connectivity between rural communities and the urban area where services originate continues to be a problem
  • Dealing with the cost of point-to-point connectivity when it exceeds $6,000 per year can steer rural communities from signing up for telehealth services
  • Dealing with the occasional dropping of a video feed due to a network outage which presents a problem for network partners


After the three year grant period, the MOST Network found:

  • Telehealth-based mental health services improved the overall mental health among clients in Madison County
  • Community Health Workers conducted classes for 27 adults and 19 adolescents which enabled knowledge related to substance abuse to rise by 27 point average and a 7 point average in adolescent clients
  • Prior to MOST, there were no Latino-focused services related to health and social services within the County, but today two individuals completed the training certification program to become Community Health Workers
  • Community Health Workers met with 24 Hispanic individuals and were able to refer their clients to various services


For more information, go to the Madison Health Resource Center Go to the Rural Health Information Hub detailing the MOST Network’s utilization of Telehealth, at

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