Why more patients are seeking behavioral health treatment

The epidemic of opioid-related addictions and deaths in recent years has drawn increased attention to behavioral health issues, such as suicide and depression, in addition to substance abuse. A new study shows growing numbers of Americans grappling with these and similar problems, with growth especially pronounced among children and young adults and those seeking treatment for substance abuse.

The study, published by the New York-based nonprofit organization FAIR Health, analyzes data from more than 28 billion insurance claims submitted to commercial payers between 2007 and 2017. Among its findings:

• Claims that included behavioral health diagnoses rose from 1.3 percent to 2.7 percent of all claims submitted during the period, an increase of nearly 108 percent.
• Claims relating to substance abuse and dependence, a component of behavioral health, grew from .1 percent to .5 percent of all medical claims, a 405 percent increase.
• Within the substance abuse and dependence category, opioid dependence surpassed alcohol dependence as the biggest source of claims, growing by nearly 1,200 percent from .016 percent to .252 percent of all claims.
• Claims for adjustment disorders-emotional or behavioral disturbances brought on by stress- among those age 19 to 30 increased from .35 percent to .62 percent of all claims. This was the largest increase among any age group.
• Claims for generalized anxiety disorder, another subcategory of behavioral health, rose among the age 14 to 17 cohort from .4 percent to 1.77 percent of all claims submitted for that cohort, an increase of 389 percent. Among the age 19 to 22 cohort, the increase was 441 percent.
• For claims related to use of stimulants other than cocaine, women outpaced men by 56 percent to 44 percent in the age 23 to 30 cohort. This finding runs counter to the usual pattern of men having higher rates of use or dependence on illicit drugs than women.

The study notes that some of the growth in behavioral health diagnoses could result from better access to mental health services made possible by the 2008 Mental Health Parity Act, which forced most commercial insurers to increase their reimbursements for behavioral health treatment.

In addition, the 2010 Affordable Care Act required health plans sold on the exchanges to include behavioral health among their covered services. The ACA also enabled people up to age 26 to remain as dependents on their parents’ health plans, thereby providing greater access to behavioral healthcare for many young adults.