Aug 28, 2023 - Health

Americans invested in their mental health during the pandemic

Photo illustration of two hands reaching out to each other, with abstract shapes and old telephones.

Illustration: Allie Carl/Axios

American spending on mental health with private insurance surged during the pandemic, according to a new study published in the scientific journal JAMA Health Forum.

Why it matters: Spending on mental health has continued to rise, even after the popularity of telehealth platforms plateaued — an increase in demand that correlates to a growing mental health crisis.

  • But researchers worry that telehealth could be covered less in the future: "Insurers may look for ways to curb costs and that could mean less flexibility about using telehealth for mental health services," wrote Jonathan Cantor, lead author of the study.

Driving the news: Diagnosis codes for anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia, and post-traumatic stress disorder were reviewed from claims from about 7 million adults from January 2019 to August 2022 by the Rand Corporation and Castlight Health researchers.

Of note: Researchers were unable to distinguish new patients, who sought mental health services during the pandemic, from those who were previously receiving care.

  • Therapy patterns, care needs and spending may differ for people who do not have employer-based private insurance, which the study focused on.

What they found: The findings concluded that treatment across the board — in person and online — increased during the pandemic. Spending on mental health services jumped 53% from March 2020 to August 2022.

  • Mental health services use increased 22% from March to December 2020, the acute phase of the pandemic. By August 2022, mental health service use was 39% higher than before the pandemic.
  • By August 2022, in-person mental health services (rather than telehealth) returned to 80% of pre-pandemic levels.
  • Spending pre-pandemic was about $2.3 million per 10,000 beneficiaries per month. It increased to about $3.5 million after the acute period of the pandemic.

What's next: Researchers said it's unclear if mental health services will continue to stay at higher rates than pre-pandemic or eventually drop.

  • "If this increased utilization affects spending, insurers may begin rejecting the new status quo," according to the study.
  • "The demand for mental health services further underscores the critical need to integrate behavioral health services into primary care," wrote Dena Bravata, a co-author of the study and researcher.

Yes, but: Patients with unmet mental health needs could increase costs for insurers in a different way, the New York Times reports.

  • They are less likely to take medications and more likely to go to emergency rooms.
  • Telehealth also makes mental health care more accessible.

Go deeper: America's therapy boom

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