There’s been a fundamental shift in how we define adulthood—and at what pace it occurs. PT’s authors consider how a once iron-clad construct is now up for grabs—and what it means for young people’s mental health today. Verified by Psychology Today
Posted February 3, 2025 Reviewed by Davia Sills
The DEA’s proposed 50/50 telehealth rule, which would require patients to have an in-person visit before continuing controlled substance prescriptions via telehealth, is a step backward in the evolution of psychiatric care. Of all medical specialties, psychiatry best lends itself to a virtual care model, and forcing patients to make an arbitrarily required percentage of in-person appointments will create barriers rather than benefits.
Telehealth has revolutionized psychiatric care by removing logistical obstacles that often prevent patients from seeking or continuing treatment. In our clinic, the impact has been overwhelmingly positive. Patients no longer need to arrange childcare, navigate unreliable transportation, or risk exposure to illness just to keep their appointments. Inclement weather and work schedules are no longer insurmountable barriers to care. As a result, compliance has improved, leading to better patient outcomes.
The requirement for half in-person visits does little to improve safety or care quality. It merely forces patients to jump through bureaucratic hoops that disproportionately affect those who are already vulnerable, such as those in rural areas, those with disabilities, and those struggling with severe mental health conditions. Mandating an in-person visit simply to “check a box” does nothing to address the real concerns surrounding controlled substances.
Instead of implementing arbitrary in-person requirements, we should focus on improving the standard of care through evidence-based practices. This includes:
1. Strengthening Identity Verification — Ensuring that both patients and providers are legitimate through secure telehealth platforms that use identity verification measures.
2. Educating Providers on Drug-Seeking Behaviors — Training clinicians to recognize red flags for substance misuse both in-person and virtually so they can make informed prescribing decisions.
3. Enhancing Safeguards for Controlled Substance Prescriptions — Implementing robust prescription monitoring programs, requiring providers to check databases for potential abuse patterns, and encouraging collaborative care models.
4. Evolving the Diagnostic Process to Include Validated Screening Tools — Ensuring clinicians utilize a comprehensive assessment process to aid in diagnostic decision-making, thereby moving away from a model of diagnosing and treating based solely on patient self-report.
Telehealth has made mental health care more accessible, reliable, and effective. The DEA should prioritize policies that enhance patient safety and provider accountability without creating unnecessary barriers to care. The goal should be to refine and improve virtual care standards, not impose outdated restrictions that disregard the realities of modern psychiatric treatment.
Let’s focus on what truly matters—delivering high-quality, accessible, and safe care to those who need it most.
References
DEA announces three new telemedicine rules that continue to open access to telehealth treatment while protecting patients. DEA. (n.d.). https://www.dea.gov/press-releases/2025/01/16/dea-announces-three-new-t…
Joel Young, M.D., teaches psychiatry at Wayne State University, and is the Medical Director of the Rochester Center for Behavioral Medicine.
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There’s been a fundamental shift in how we define adulthood—and at what pace it occurs. PT’s authors consider how a once iron-clad construct is now up for grabs—and what it means for young people’s mental health today.
