May ushers in springtime renewal and hope. However for many Americans, mental health challenges can dim the light on any season. The Clarify Health Institute (CHI) is dedicated to research that highlights the state of mental health in the United States. Last September the institute released a stunning brief, The Kids Are Not Alright, focusing on the utilization of mental health services among children and teenagers (up to 19) with mental health conditions. Later this month, CHI will continue its support of Mental Health Awareness Month with new research that looks at the use of mental health services among ALL children and young adults up to 21 years old. Today, we are focused on the mental health and well-being of adults. To help foster a better understanding of mental health challenges, CHI has analyzed the increasing prevalence of mental health conditions and the utilization of mental health services among adults in the United States. Our findings emphasize the need for increased awareness and targeted interventions to improve mental healthcare access and utilization. The overall prevalence of mental health conditions among adults increased by 16% between 2017 and 2022, based on CHI’s analysis of commercial and managed Medicaid claims. This notable increase is consistent with survey evidence showing that one in five US adults experiences mental illness each year. In particular, since 2017 anxiety and fear disorders have increased by 30% and trauma and stress-related disorders increased by 38%. Depressive disorders saw only a slight increase of 2% during the same period. The overall growth rates shown in the figure do hide some year over year volatility; declines in 2020 were followed by peaks in 2021, highlighting the impact of the COVID-19 pandemic on mental health. Prevalence of suicide and other self-harm has also increased by 10% from 2017 to 2022, further emphasizing the importance of mental health awareness and access to resources. Utilization of mental health services across three categories – emergency department (ED) visits, inpatient hospital (IP) admissions, and office/outpatient (MD/OP) professional visits – show varying patterns. Strikingly, IP visits per 1,000 patients increased 54% from 2017 to 2022 Q2. However, emergency room professional visits per 1,000 patients have overall increased only 2.6% (i.e., for mental health conditions and not considering substance use disorder principal diagnoses). Meanwhile, the annual rate of MD/OP professional visits for mental health treatment has grown 25%; on average, the average adult in the US receives around 1 MD/OP professional service each year for mental health treatment. Clarify Health Institute’s analysis underscores the need for targeted interventions to improve mental healthcare access and utilization, with nearly 20% of adults having a documented mental health condition as of 2022. As we enter Mental Health Awareness Month, it is crucial for individuals, health systems, payers, and policymakers to work collaboratively to address the challenges associated with mental healthcare access, early detection, and treatment. To alleviate the burden of mental health conditions and improve the quality of care, some key strategies include: Raising public awareness about mental health and reducing stigma associated with mental health conditions. Expanding access to mental healthcare services, particularly for underserved and vulnerable populations. Enhancing integration of mental healthcare into primary care settings to facilitate early detection and treatment. Supporting the development and dissemination of evidence-based interventions and best practices in mental healthcare. Encouraging ongoing research and data collection to better understand mental health prevalence and utilization trends, and inform targeted interventions. By working together to address these challenges, we can make a lasting impact on the mental health and well-being of individuals and communities across the nation. With our trend analysis demonstrating increasing prevalence and acuity of adult mental health conditions, Clarify Health fully endorses the ‘More Than Enough’ campaign for 2023 Mental Health Awareness Month. No matter where you are on your mental health journey, you are deserving of support, resources, fulfillment and a community that cares. During Mental Health Awareness Month, CHI will offer practical tips and resources to help individuals, families, and healthcare communities navigate the complexities of mental health treatment. Join us as we embark on a journey to better understand the nuances of mental health, embrace the power of empathy, and cultivate a supportive and inclusive community. Together, we can make a lasting impact on the lives of those affected by mental health challenges and pave the way for a brighter, more compassionate future.Increasing Prevalence of Mental Health Conditions
Mental Health Utilization Trends
Implications and Recommendations
Presented analyses utilize a combined commercial and Medicaid managed care claims data source leveraging data from multiple payers across the US. Our sample includes an average 59 million adults aged 18-99 years old annually from 2017 – 2021. We identify and categorize mental and behavioral health conditions using AHRQ CCSR condition categories. Specifically, we present results among children identified with the mental and behavioral disorder (MBD) categories, defined by ICD-10 diagnosis codes, for: Depressive disorders (MBD002) Other specified and unspecified mood disorders (MBD004) Anxiety and fear-related disorders (MBD005) Obsessive-compulsive and related disorders (MBD006) Trauma- and stressor-related disorders (MBD007) Disruptive, impulse-control and conduct disorders (MBD008) Feeding and eating disorders (MBD010) Suicidal ideation/attempt/intentional self-harm (MBD012) Neurodevelopmental disorders (MBD014) Diagnosis rates (i.e., prevalence rates) are calculated among individuals observed with at least six months continuous enrollment in the current year. Diagnoses are identified for a patient in a given year if a diagnosis code for the same MBD condition category was identified via an ICD-10 diagnosis code on any claim. Utilization rates by claim type (i.e., counts of inpatient, emergency department, and office/outpatient professional visits) are estimated for claims with a mental health primary diagnosis among patients enrolled in either commercial insurance or Medicaid in the current year. In comparing utilization across years, we compare fully mature claims data from 2016 to 2022 Q3. Utilization values for 2022 Q4 are imputed based on prior year estimates. Utilization results are case-mixed adjusted to account for any sample population age- or sex-differences over time. We standardize estimates to the 2019 calendar year, adjusting annual estimates to match the age and sex distributions in this reference year.Data Notes
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