Telehealth Mental Health Demand Across English-Speaking Markets

Across Australia, Canada, the United Kingdom, New Zealand, Ireland and the United States, demand for telehealth mental health care has been rising for years, not months, and official data from each system shows capacity struggling to keep pace. What that strain looks like differs by country — a growing caseload here, a lengthening wait there, a rising rate of unmet need elsewhere — but the practical consequence for a clinic offering virtual consults is the same wherever it operates: more of a new patient’s first contact now happens over a phone line or a message thread, not a waiting-room chair, and a missed one there rarely gets a second try.

Demand kept climbing well after the pandemic-era reason for it faded

The easy explanation for telehealth’s growth is COVID-19: clinics went virtual out of necessity, and some of that stuck. The data suggests something more structural was already underway before, and has continued after, any pandemic-specific push. In Australia, the Australian Institute of Health and Welfare reports close to 13.2 million mental health services delivered under Medicare — Australia’s universal claims and rebate scheme, not to be confused with the US insurance program of the same name — in 2022–23, reaching roughly 2.7 million people, about 10% of the population. In Canada, Statistics Canada’s Mental Health and Access to Care Survey found the share of adults meeting diagnostic criteria for a major depressive episode rose from 4.7% in 2012 to 7.6% in 2022, with generalized anxiety disorder roughly doubling, from 2.6% to 5.2%, over the same decade.

In the United States, the CDC’s National Center for Health Statistics recorded a rise in the share of adults aged 18–44 receiving any mental health treatment — medication, counselling, or both — from 18.5% in 2019 to 23.2% in 2021, and a separate NCHS brief found 37.0% of US adults used telemedicine for any purpose in the 12 months to 2021. None of these figures describe a short-lived spike. They describe a multi-year climb that different national statistical offices, working independently, all happened to record at roughly the same time.

These figures are not measuring the same thing, and treating them as one series would be a mistake

It is tempting to line these numbers up as a single regional trend. That would be a mistake, and it is worth saying plainly before going further: Australia’s 13.2 million counts services claimed under a national rebate scheme. Canada’s 7.6% counts diagnostic criteria met in a household survey. England’s 476,278 counts new referrals logged in one calendar month by a public system with statutory reporting duties. The United States’ 37.0% counts any telemedicine use, not mental health specifically, self-reported in a health interview survey. Each is a legitimate, well-constructed statistic from a credible national body — and none can be divided by another to produce a meaningful ratio. Different denominators, different legal definitions of a “service” or “referral,” and different survey instruments sit behind each number. Country-specific regulators and vocabulary make the systems themselves genuinely not comparable, not just the numbers they publish.

That gap in what gets measured is itself informative. Ireland’s Central Statistics Office only began publishing an annual, harmonised indicator for population-level depression through its Irish Health Survey in 2024 — too recent for a multi-year trend, where England and Canada can already show a decade. Vocabulary compounds it: a “referral” in the NHS is a specific administrative event with its own reporting standard; a Medicare “service” in Australia is a billed item; a person “not having their needs met” in a Canadian survey is a self-report with no clinical verification behind it. Reading across borders without naming which instrument produced which number is how a regional post turns into misleading arithmetic.

Where the data does line up: the workforce and the wait are moving in opposite directions from need

Even without a shared unit, one pattern repeats closely enough to state with confidence: reported need is climbing faster than the systems built to meet it. New Zealand’s Mental Health and Wellbeing Commission, Te Hiringa Mahara, found 14.3% of adults — around 619,000 people — experienced high or very high psychological distress in the four weeks before the 2024/25 New Zealand Health Survey, significantly higher than five and ten years earlier. Over that period, the number actually using specialist mental health and addiction services fell rather than rose: the Commission’s own service-monitoring data recorded 176,261 people using specialist services in 2023/24, down from 179,472 the year before and more than 16,000 fewer than in 2020/21.

Distress rising while service use falls is not proof of a single national bottleneck — funding, workforce, referral pathways and eligibility rules all move independently, and the Commission’s own report notes real gains too, including a 49% rise in mental health and addiction expenditure over five years. But it is consistent with what other markets report through their own instruments: not a shortage of people asking for care, but a system that cannot always turn “asking” into “seen.” England’s 476,278 new referrals in a single month, cited earlier, arrive on top of 1.65 million adults already carrying an open mental health referral — a caseload NHS Digital reports growing, not shrinking, month over month.

The pattern that actually holds across every one of these systems

None of the national statistics above — not Australia’s claims data, not Canada’s survey, not England’s referral counts, not New Zealand’s service tallies — measure the moment a person first tries to make contact with a clinic. AIHW counts services delivered. Statistics Canada counts people who report unmet need, sometimes months after the fact. NHS Digital counts a referral once it has already been logged. None of them can see the call that rang out, the message that got no reply, or the person who tried once and did not try again.

That gap matters more in mental health than in most other kinds of care, and it matters roughly the same amount regardless of which system a clinic sits inside. Reaching out for a first mental health appointment is, for a meaningful share of people, a decision that took real effort to arrive at. A missed call about a routine dental check-up is usually followed by another call that afternoon. A missed call from someone trying to book a first psychology or psychiatry consult, made in the narrow window they had set aside for it, does not reliably get a second attempt that day — and with reported need already outpacing capacity in the data above, there is little slack to absorb people who give up and never call back.

Telehealth widens that gap rather than closing it. Removing the need to travel to a physical location opens the door to people who would never have shown up in a waiting room in the first place — someone in a regional area with no local psychiatrist, a shift worker whose only free hour is 9pm, a person who can message a clinic more easily than they can walk into one. Those are, in many cases, exactly the people the figures above suggest each system already struggles to reach through its existing channels. If the first point of contact still depends on a receptionist answering a landline during standard business hours, telehealth has removed one barrier only to leave the oldest one — whether anyone picks up — firmly in place.

What continuous intake coverage looks like, market by market

None of the national data changes what an individual clinic controls, which is what happens in the seconds after someone tries to reach it. That holds whether the clinic bills a Medicare item in Melbourne, works inside a provincial referral pathway in Ontario, sits on an NHS waiting list in Leeds, runs a private practice in Auckland, operates under HSE-funded and private mixed care in Dublin, or takes commercial insurance in Denver. The regulator and the vocabulary for “appointment” change at the border. The value of answering the phone the first time does not.

Closing that gap doesn’t require hiring reception staff to cover hours nobody wants to work, and it doesn’t require solving the workforce or funding questions the data above describes — those sit with national systems, not individual clinics. It requires making sure the front door itself is never closed: that a call, a WhatsApp message or an SMS asking to book a first telehealth mental health consult gets answered and the appointment confirmed, whatever time it arrives, however busy reception is, and whichever of these six systems the clinic operates inside. That is the specific problem Arbol is built for — an AI voice, WhatsApp and SMS agent that answers a clinic’s intake line and messages instantly, day or night, takes the caller’s details, and moves them into the booking flow, so growth in demand for telehealth mental health care shows up as a confirmed appointment, not a call nobody picked up.

For more on how continuous intake coverage fits into everyday clinic operations, see the Arbol homepage. The same first-contact gap plays out differently country by country — see how it shows up in Australia’s telehealth mental health system, in Canada’s virtual mental health access, and on the NHS mental health waiting lists in the UK.