Rapid Creation of Child Telemental Health Services During COVID-19 to Promote Continued Care for Underserved Children and Families

The COVID-19 pandemic prompted the rapid transformation of child mental health services from mostly in-person to fully remote delivery at an urban safety-net hospital. No-show rates substantially declined when implementing video visits, and the volume of service delivery was unchanged compared to prepandemic in-person visits. In addition, no-show rates for telehealth sessions did not increase over time. Recommendations for telehealth quality assurance and improvement to best respond to children and families with existing mental health needs and limited resources during disasters and in their aftermath are suggested. Impact Statement Rapid conversion to child telemental health service provision for publicly and uninsured, minoritized youth and families is feasible. Our clinic conversion did not result in substantial decreased service delivery volume, nor increased no-show rates and was sustained over time. Still, approximately 20% were not reachable; thus, as the COVID-19 pandemic continues, implementation of safe and creative quality improvement processes to increase telehealth reach, engagement, and retention are of paramount focus, as is a readiness to respond to unknown future disasters.