Tablets and Telehealth: Expanding Care Reach for Stigmatized Health Conditions

Abstract Introduction Stigmatized health conditions create disclosure costs that suppress care-seeking in ways that logistical access alone cannot resolve. Digital infrastructure enabling telehealth access holds promise for reaching these populations because remote access reduces the visibility of care-seeking. Yet device access remains a barrier, with little evidence on whether internet-enabled device distribution programs can expand care for high disclosure-cost populations. Methods Using an event-study and difference-in-differences framework, this study exploits the VA’s escalated distribution of video-enabled tablets during the COVID-19 pandemic to identify the impact of closing the digital divide on continuity of virtual mental health care among female veterans with a history of MST and examines variation in impact by clinician characteristics. Results Tablet recipients experienced a 27 percent increase in continuity of care and attended 2.5 more psychotherapy visits per year for both general mental health and trauma-related concerns. Effects were larger among patients matched with female or female-serving clinicians, suggesting that device access and clinician characteristics may work together to facilitate care for trauma survivors. Conclusion These findings suggest that public investment in digital infrastructure, paired with intentional patient-provider matching, can expand mental health care reach for patients whose barriers extend beyond logistics to the visibility of care-seeking.