The utilization of mental health services experienced a significant surge amid the COVID-19 pandemic, facilitated by the accessibility of teletherapy, which mitigated obstacles to regular appointments. A comprehensive analysis of insurance claims, featured in Friday’s publication of JAMA Health Forum, unveils these trends.
Over the period from March 2020 to August 2022, there was a remarkable 39 percent rise in mental health visits and a corresponding 54 percent increase in spending. The study, scrutinizing 1,554,895 claims related to clinician consultations, also highlighted a remarkable tenfold uptick in telehealth utilization.
The study encompassed around seven million adults across the nation who are covered by health insurance through their employers. Notably, it excluded individuals with severe mental illnesses and did not encompass acute or residential care.
Despite insurers grappling with the decision to continue elevated payments, the study’s co-author, Christopher M. Whaley, a health care economist at the RAND Corporation, anticipates that these trends will endure.
“This entails significant costs, which are ultimately borne by policyholders through higher premiums and increased deductibles,” remarked Mr. Whaley, also an associate professor at Brown University.
On the flip side, individuals with unmet mental health requirements are prone to medication non-adherence and a higher likelihood of resorting to emergency rooms during crises. These behaviors also impose substantial costs on insurance pools.
Mr. Whaley stated, “The dilemma for insurers, and what the healthcare system should contemplate, is determining which cost is ultimately more substantial.”
A predominant portion of mental health visits focused on anxiety and depression, accounting for 45 percent and 33 percent of total visits, respectively. Visits for post-traumatic stress disorder constituted 10 percent, while bipolar disorder and schizophrenia accounted for 9 percent and 2.6 percent, respectively.
Among these categories, anxiety disorders observed the most substantial surge in visits during the pandemic, with an increase of 73.7 percent. Visits for PTSD increased by 37 percent, bipolar disorder visits by 32 percent, and depression visits by 31.9 percent. Notably, visits for schizophrenia remained unchanged.
Surprisingly, researchers discovered that the utilization of telehealth for mental health did not wane after the pandemic, in contrast to its decline in other medical domains.
Mr. Whaley noted, “This is an aspect of the healthcare system where patients and providers are essentially voting with their actions. It appears to be a shift that persists beyond the pandemic.”
The upswing in mental health service utilization reflects both diminishing stigma and reduced practical barriers to accessing mental health care, according to Dr. Robert L. Trestman, head of psychiatry at Virginia Tech’s Carilion School of Medicine, who oversees a psychiatric system in western Virginia.
In his system, Dr. Trestman noted a substantial surge in billing for patients with anxiety and depression during the pandemic years. Traditionally, nearly half of individuals displaying symptoms of these disorders did not seek mental health care.
As more individuals seek care, these numbers align more closely with the anticipated underlying epidemiological patterns, Dr. Trestman commented.
