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New Report Calls for Innovative Solutions to Address Behavioral Health Crisis

Analysis  |  By Eric Wicklund  
   March 10, 2023

A new study from Trilliant Health finds that the number of people needing help for behavioral health issues is outpacing the healthcare industry's efforts to meet demand, and driving a need for more and better telehealth and digital health services.

The surge in demand for behavioral health services is pushing providers to embrace telehealth and digital health solutions, according to a new report.

The report, Trends Shaping the Health Economy: Behavioral Health, from analytics and market research firm Trilliant Health, finds that behavioral health visit volume has jumped 18% over pre-pandemic levels, and the percentage of virtual visits for behavioral health concerns has surged from 34.4% in 2019 to 63.8% in 2022.

This increase, the study noted, isn't driven by frequent users, but by those seeking help for the first time or occasionally: Some 66% of patients diagnosed with a mental health condition saw a care provider five or fewer times per year.

And it's driving up costs. According to the report, behavioral health issues can exacerbate other health issues, such as diabetes or hypertension, driving up cost by some 20%.

Combined with noted increases in patients seeking specialized behavioral care services and the use of prescription drugs, the study paints a picture of an industry struggling to catch up.

"While the magnitude of the national behavioral crisis is well documented, less is known about how the pandemic changed the behavioral healthcare journey for patients," Sanjula Jain, PhD, Trilliant Health's chief research officer and SVP of market strategy, said in a press release accompanying the report. "Our longitudinal analysis of how Americans accessed care and were treated for behavioral health conditions reveals that, despite increased investments in technology-enabled behavioral health services and inpatient psychiatric capacity, demand continues to outpace available supply."

“This mismatch is already resulting in fewer patients receiving specialized behavioral healthcare, increased prescription use and comorbidity risk, while also growing the total cost of care," Jain added. "These distressing trends suggest that by the laws of economics, the post-pandemic behavioral health market will likely increase the economic burden facing the US healthcare system, which is already fast approaching 20% of GDP.”

The study, compiled from claims databases, also found that the demand for and use of prescription drugs in behavioral health has grown to 21.5% of all prescriptions in 2021. One alarming trend is the prescription of Adderall or its generic equivalent for treatment of ADHD for patients age 22-44. That segment of the population saw a 58.2% increase in prescriptions from 2018 to 2022, while other age groups remained relatively consistent before and after the pandemic.

As for specific behavioral health concerns, anxiety and depressive disorders accounted for 40% of all behavioral health visits in the first half of 2021, yet the condition with the highest increase since 2019 was eating disorders (52.6%). That was followed by anxiety (47.9%), alcohol- and substance-abuse (27.4%), depression (24.4%) and bipolar disorder (12.2%).

The report also finds that those under 18 years old are in need of behavioral health services more than any other age group – with diagnoses for eating disorders more than doubling between 2018 and 2022, followed by depressive disorders (44%). And prescription for this age group jumped 35% over the same time frame.

The jump in virtual visits for behavioral health means that fewer people are seeking help at the hospital. According to the report, the overall share of behavioral health visits to the ED has decreased over the past four years.

But there's a catch. Of those going to the ED for treatment for depression or anxiety, almost half didn't receive follow-up care within 60 days, and 84% of patients seeking treatment for alcohol or substance abuse disorder didn't seek follow-up care at a inpatient or residential treatment center within 60 days. In fact, almost 10% of those patients returned to the ED within 30 days.

The upshot of the study is that America's healthcare industry isn't keeping up with the surge of people needing help for behavioral health issues, even as more healthcare organizations embrace digital health and telehealth to address access issues. The challenge lies not only in adding virtual care alongside in-person care but making the process as easy and intuitive as possible.

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.


KEY TAKEAWAYS

Behavioral health visit volume has jumped 18% over pre-pandemic levels, especially among those 18 and under, and the percentage of virtual visits has surged from 34.4 % in 2019 to almost 64% in 2022.

This increase has fueled a surge in the need for specialty care, and is increasing overall healthcare costs by some 20%.

The study points to a need for the industry to embrace telehealth and digital health and look for ways to make healthcare access seamless and intuitive.


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