12 behavioral health trends shaping the economy

Demand for behavioral health care has dramatically increased since the start of the COVID-19 pandemic.

Behavioral health visit volumes were relatively flat prior to 2020, by Q2 2022, they were 18 percent above pre-pandemic levels, and demand grew faster than the national average in nine of the 10 largest metropolitan area, according to a new report from Trilliant Health.

Unlike other aspects of healthcare, behavioral health trends are not a function of a small group of high utilizers driving higher volumes, according to the report. In 2021, 66 percent of patients diagnosed with a mental health condition saw a provider five or fewer times that year.

Seven things to know from the report:

1. Anxiety and depressive disorders drove much of the increase and represented 40 percent of all behavioral health visits in the first half of 2021.

2. Since 2019, visit volume for eating disorders grew the most (52.6 percent), followed by anxiety (47.9 percent), substance use disorders (27.4 percent), depression (24.4 percent) and bipolar disorder (12.2 percent).

3. Behavioral health accounts for a greater share of telehealth visits. In Q2 2019, behavioral health represented just 34 percent of telehealth visits, but by Q2 2022, they accounted for 64 percent. 

4. However, behavioral health services are delivered approximately 45 times more often via telehealth than before the pandemic. Less than 1 percent of all behavioral health visits were virtual in 2019, but that rose to 33 percent by Q2 2022.

5. Behavioral health demand forecasts reveal that by 2026, 25 percent of Americans will require behavioral health services, which is 1.2 percentage points above observed 2021 levels. This proportion could be even greater when factoring in the effects of policies such as new screening recommendations from the U.S. Preventive Services Task Force.

6. From 2018 to 2021, behavioral health visits increased the most for psychiatric nurse practitioners (79.8 percent) and declined the most for psychiatrists (-1.3 percent).

7. The report found an 18 percent surge in behavioral health visit volumes, resulting in rising rates of comorbidities and increased overall spending.

8. The supply of psychiatrists dropped by 2.8 percent, made worse by the uneven geographic distribution of providers. 

9. Americans under 18 are experiencing higher diagnosis rates of select behavioral health conditions, including a 107 percent rise in eating disorder diagnoses among youths.  

10. The proportion of American adults taking medication to manage behavioral health issues is increasing, with 21.5 percent of Americans having a mental health-related prescription in 2021. 

11. The report found a 58.2 percent increase in Adderall prescription volume for patients ages 22-44 from Q1 2018 to Q2 2022. 

12. Prior to the pandemic, less than 2 percent of stimulants were prescribed via telehealth, but that proportion rose to 39.4 percent in 2021.

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