The Nation’s Mental Health: Stress is up, treatment is not


Our nation reported more mental health stress in 2020, but there was not a corresponding increase in people seeking mental health treatment, according to the inaugural State of the Nation’s Mental Health report.

However, there were two conditions for which diagnoses and treatment grew in 2020: anxiety and PTSD for adults. These findings support the results of a recent study showing that four out of 10 U.S. adults reported symptoms of anxiety or depression in 2020, up from one in 10 in 2019.

The report’s findings, based on behavioral health plan claims from 27 million people in the United States, reflect the pandemic disconnect between feeling stressed and depressed and being diagnosed and seeking treatment.

Two groups had the largest overall downturn: younger children and older adults. One possible reason for the drop in children’s diagnoses is that they spent less time with teachers, coaches and other mentors during the pandemic. The Silent Generation — people 75 and older — may not have used telehealth services as much as other groups and delayed getting health care appointments.

The State of the Nation’s Mental Health report showed the following drops in 2020 rates for those treated for mental health diagnoses compared with those treated in 2019:

10 percent overall drop for
young children

5 percent overall drop for adolescents

5 percent overall drop for adults older than 75

13 percent drop for young children diagnosed with ADHD

8 percent drop for adolescents diagnosed with ADHD

8 percent drop in adults older than 75 diagnosed with dementia

3 percent drop for both Baby Boomers and adults older than 75 diagnosed for depression

The results of the study are supported by data from IngenioRx, a pharmacy benefits manager. While the overall use for depression medications was up in 2020, much of that increase is due to existing users being better about taking their medications as prescribed, according to IngenioRx medication data. New users of these medications increased at the same rate as 2019.

“It’s not surprising that the COVID-19 pandemic has affected people’s mental health,” commented Neil Leibowitz, MD, JD, chief medical officer/behavioral health at Beacon Health Options, a leading behavioral health services company. “However, because people aren’t seeking services at a rate we would expect them to, it’s a reminder that we all need to understand what people are going through and do what we can to make sure they get care. We encourage people to get the COVID-19 vaccine to protect their physical health. Likewise, we need to encourage people to practice self-care and get treatment to protect their mental health.”

Many health care professionals believe the pandemic will affect our nation’s mental health for years to come. Nearly three out of four mental health specialists and primary care doctors estimate that the mental health effects from the pandemic will last up to three years or longer, according to an Anthem Inc.-commissioned survey.

The pandemic has highlighted the importance of mental health for doctors and patients alike. Nine out of 10 of surveyed providers reported they are more aware of their patients’ mental health challenges. Also, 70 percent said their patients have been more willing to bring up mental health issues during appointments.

“There is no doubt that 2020 was the most difficult of years,” said Dr. Leibowitz. “However, the year presented us with an opportunity. This reported uptick in awareness shows promise that attitudes concerning mental health are changing. I don’t think we have yet to see the end to mental health stigma, but assuming this data reflects a larger national trend, 2020 led us closer to an openness around discussing mental health.” 

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