The U.S. is currently experiencing a dramatic rise in behavioral health needs, in large part due to the COVID-19 pandemic. We are committed to listening to those on the front lines of the pandemic and analyzing our own data to deepen our understanding of the communities we serve. As part of these efforts, we recently released an inaugural report, State of the Nation’s Mental Health, which is based on an analysis of more than 27 million healthcare claims and a nationwide clinician survey. In Part 2 of our three-part series, we explore why rates of behavioral health diagnoses have remained stagnant or decreased over the past year. Our final post will explore the ways in which the pandemic may be changing individuals’ view of mental health. Click here to read Part 1.

During the COVID-19 pandemic, four in ten American adults reported symptoms of anxiety or depression, up from one in 10 in 2019. In addition to this startling 150 percent increase, half of adults reported negative impacts to their behavioral health, such as difficulty sleeping or eating, increased alcohol consumption or substance use, and worsening chronic conditions, due to worry and stress over the coronavirus.

4 in 10 adults reported symptoms

In light of the increase in behavioral health concerns, it is not surprising that an Anthem survey of more than 500 behavioral health specialists, primary care physicians, and general practitioners found almost unanimous agreement (97%) that COVID-19 has raised awareness of the importance of mental health. However, an analysis of 2020 member data shows that there was little change in the rate of behavioral health diagnoses. Among some populations, there was even a slight decrease.

What accounts for this discrepancy? For one, the pandemic disrupted individuals’ normal patterns of care for both mental and physical health. A report from the Centers for Disease Control and Prevention found that 41 percent of U.S. adults avoided or delayed receiving medical care during the pandemic, despite an uptick in telehealth services. And during a time when social distancing measures kept many people at home, healthcare professionals found that many of their patients opted for the convenience and ease of self-care methods like purchasing exercise equipment or watching videos on how to manage stress through meditation.

Decreases in diagnosis among age groups

Age also played a role in decreased diagnosis rates. Our report found that children, adolescents, and adults aged 75 and older appeared to have the largest overall downturn in diagnoses in 2020 compared to 2019. There was a 10 percent drop in the rate of young children and a 5 percent drop for adolescents treated for mental health diagnoses compared to 2019. At the opposite end of the age spectrum, adults aged 75 and older —sometimes referred to as the Silent Generation—also showed a 5 percent drop. For children, one likely explanation for the drop in diagnoses is that they had fewer face-to-face interactions with individuals like teachers and coaches who can flag a need for a behavioral health intervention. Among the Silent Generation, an explanation could be they’re less likely to adopt telehealth services and had fewer visits with healthcare providers.

Our whole-health approach can help bridge the gap between increased need and care delivered. We will continue our work to integrate behavioral health into primary care, encouraging and supporting clinicians to screen consumers for behavioral health conditions in a primary care setting and referred to specialists by physicians they know and trust.