Covid-19 and the Changing Landscape of Behavioral Health Services
Grief, unemployment, restrictions on social interactions, and other pandemic-related stressors have put Americans at risk of worsening mental health. Between August 2020 and February 2021, there was a significant increase in the percentage of adults who reported having symptoms of an anxiety or depressive disorder in the last seven days (from 36.4% to 41.5%, respectively). Moreover, the percentage who reported needing, but not receiving, mental health counseling or therapy in the last four weeks also rose from 9.2% to 11.7%.1 A study conducted by Lindau et al. (2021) suggests that among women, the rates of depression and anxiety were twice that of pre-pandemic benchmarks (29%) by April of 2020.2
Help-seeking for mental health treatment is on the rise, according to data reported by the CDC. According to a 2022 NCHS Data Brief 3, the percentage of adults who received any mental health treatment in the past 12 months rose 2.4 percentage points, from 19.2% to 21.6%, between 2019 and 2021. Adults were considered to have received mental health treatment if they reported receiving counseling or therapy from a mental health professional, taking medication for their mental health, or both, in the last 12 months. Researchers note that the largest increase was seen in adults age 18-44. Within that age group, women were more likely than men to have received mental health treatment. Non-Hispanic white adults were the most likely to have received any mental health treatment. The percentage of Non-Hispanic black adults who received mental health treatment increased in 2020 (17.0%) and fell again in 2021 (14.8%). Non-hispanic Asian adults had some of the lowest rates of receiving mental health treatment in the past 12 months, with only 6% reporting having done so in 2019, 8.2% in 2020, and 10.8% in 2021.
While many groups are having their behavioral health needs met through traditional modalities like counseling and medication, others are not. According to HRSA, 157 million Americans live in federally-designated Health Professional Shortage Areas (HPSA) for mental health.4 HPSAs identify areas that are experiencing a shortage of health professionals, including health professionals in the areas of primary care, dental, and mental health. Areas that are designated as HPSA must have a ratio of population to providers of at least 30,000 to 1. 5 As of November 2022, there are 6,469 HPSAs in the area of mental health, and an estimated 7,902 psychiatrists and other mental health providers are needed to fill the gap. 4 According to experts, other types of mental health professionals are overwhelmed by demand. This includes psychologists and social workers. 6 Factors that are driving the psychiatry gap include a growing population, lack of residency seats in psychiatry, and a retirement drain of aging psychiatrists. Innovative solutions are needed to meet the behavioral health needs of these populations. While some providers are focusing on telemedicine as a way to extend access to behavioral therapy beyond the 9-5 practice, others are opting to refer patients to digital, self-paced programs. With many states ending pandemic-era waivers that enabled behavioral health providers to provide services across state lines 7, self-guided modules offer providers a pathway to deliver behavioral health solutions at the point of care and connect patients with much needed support in a way that is flexible, accessible, and evidence-driven.
References
1 Vahratian A, Blumberg SJ, Terlizzi EP, Schiller JS. Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. MMWR Morb Mortal Wkly Rep 2021;70:490–494. DOI: http://dx.doi.org/10.15585/mmwr.mm7013e2
2 Stacy Tessler Lindau, Jennifer A. Makelarski, Kelly Boyd, Kate E. Doyle, Sadia Haider, Shivani Kumar, Nita Karnik Lee, El Pinkerton, Marie Tobin, Milkie Vu, Kristen E. Wroblewski, and Ernst Lengyel.Change in Health-Related Socioeconomic Risk Factors and Mental Health During the Early Phase of the COVID-19 Pandemic: A National Survey of U.S. Women.Journal of Women’s Health.Apr 2021.502-513. http://doi.org/10.1089/jwh.2020.8879
3 Terlizzi EP, Schiller JS. Mental health treatment among adults aged 18–44: United States, 2019–2021. NCHS Data Brief, no 444. Hyattsville, MD: National Center for Health Statistics. 2022. DOI: https://dx.doi.org/10.15620/cdc:120293.
4 https://data.hrsa.gov/topics/health-workforce/shortage-areas