global health there is an increasing demand for telemental health services in low- and middle income countries. this is especially pronounced due to the lack of access to quality healthcare, underfunding and low awareness of mental health issues. in a global health context telemental health may offer access to high-quality mental health services for a wider range of people. at the same time there are concerns around data security and challenges regarding proper infrastructure, capacity, access and skills. telemental health during the covid-19 pandemic due to lockdowns or ‘stay at home’ orders at the start of the covid-19 pandemic, mental health services in high-income countries were able to adapt existing service provision to telemental health care. estimates suggest that between 48% to 100% of service users who were already receiving care at the start of the pandemic were able to continue their mental health care using remote methods. some face-to-face appointments still took place if necessary. during the pandemic telemental health care (mostly phone and video calls) was effective and viewed as acceptable by the majority of clinicians and service users for use in an emergency situation. however both groups had concerns regarding the longer term use of telemental health care. for example, clinicians identified concerns including difficulties with medication appointments, concerns around engaging and assessing new patients, and finding it harder to assess some physical indicators of mental health status remotely. service users identified barriers including a lack of private space at home to access during their sessions or access to technology. the rates of telemental health use seem to have declined as covid-19 restrictions were loosened, indicating that face-to-face care might be preferable for some service users and clinicians.