The Persistent Demand for Mental Healthcare and the Role of SDOH

The following is a guest article by the Healthcare Business of LexisNexis® Risk Solutions

The COVID-19 pandemic has profoundly transformed the landscape of mental health in the United States. While the virus itself posed an immediate threat to physical health, the ripple effects of the pandemic have led to a significant and persistent mental health crisis. Isolation, loneliness, and access to healthcare, including vaccines, have emerged as critical social determinants of health (SDOH) factors that have significantly impacted mental health outcomes.

SDOH are non-medical factors that influence health outcomes. These can include economic stability, education, social and community context, health and healthcare access, and neighborhood and environment. Understanding these factors is essential for healthcare organizations aiming to reduce health disparities and improve long standing health equity challenges, specifically in vulnerable populations and underserved communities.

SDOH can impact treatment and an individual’s mental health by affecting their ability to access care, adhere to treatment and maintain a supportive environment for recovery.

Three Key SDOH Statistics:

1. Impact of Financial Health on Medication Adherence: A study by Express Scripts found that enrolling individuals in financial assistance programs improved medication adherence by 7% among patients with inflammatory conditions, highlighting the significant role of financial health in patient compliance.
2. Distance to Nearest Relative Affects Medication Adherence: scientists at LexisNexis Risk Solutions identified that individuals whose nearest relative or associate lives more than 25 miles away are less likely to adhere to their medications, indicating the importance of social support in health outcomes.²
3. Predicting Housing Instability: Incorporating SDOH data significantly increased the ability to predict housing instability, with a 6.56% improvement when combining state data with LexisNexis Risk Solutions data, compared to state-only data.³ This underscores the value of comprehensive SDOH data in identifying at-risk individuals.

For instance, individuals in lower socioeconomic groups may face barriers to accessing mental healthcare due to lack of insurance, transportation, or availability of providers. Educational disparities can also contribute to differences in mental health outcomes, as lower levels of education are often associated with increased stress and fewer resources for coping with mental health issues.

Because of the effect of the pandemic on SDOH factors, the demand for mental health services has surged to unprecedented levels. Understanding these trends is crucial for healthcare organizations seeking to address the complex and evolving needs of their populations and reduce barriers to care.

Rising Mental Health Claims: A Reflection of Growing Demand

What organizations do have after the pandemic is a wealth of data on care utilization trends. By analyzing comprehensive data on mental health claims, healthcare organizations can gain valuable insights into the trajectory of mental health conditions and the influence of SDOH factors, providing a clearer picture of where healthcare interventions and innovations may be most needed.

According to a recent data analysis by LexisNexis Risk Solutions from their LexisNexis® MarketView™ platform of claims analytics, mental health claims have risen 83% from 2019 to 2023, with an 11% increase between 2022 and 2023 alone.

The analysis of de-identified medical claims data from 2019 through 2023 shows a significant increase in mental health visits across nearly every condition. While the pandemic initially drove a surge in telehealth visits for mental health conditions, this trend has seen a reversal among children under 18, with a 14% drop from 2022 to 2023.

Meanwhile, in-office mental health visits have increased across all age groups during the same period, indicating a shift back to traditional modes of care. 

Highlights of Key Mental Health Trends

The analysis revealed several key trends in mental healthcare utilization:

1. The Effects of Stress and Anxiety: Among patients of all ages, stress and anxiety have seen significant increases in both the number of patients and claims. Stress-related claims rose by 86%, and anxiety-related claims increased by 72% from 2019 to 2023.
2. Developmental Disorders and Depression: Developmental disorders and depression also saw substantial rises, with claims for developmental disorders up by 75% and depression-related claims increasing by 52% over the same period.
3. Youth-Specific Trends: Among patients under 18, there were dramatic increases in claims for gender identity issues (152%), eating disorders (131%), and phobic disorders (98%).
4. Shift from Virtual to In-Office Care: The initial surge in telehealth visits for mental health conditions during the pandemic has begun to reverse, especially among children under 18. This shift underscores the need for flexible and hybrid care models that can adapt to changing patient preferences and access issues.

The persistent increase in mental health claims points to underlying health inequities that must be addressed to provide equitable care. For example, the rise in claims for stress, anxiety, and developmental disorders suggests that certain populations may be disproportionately affected by these conditions. This is where social determinants play a crucial role.

Leveraging Data to Address Health Inequities

Data on claims trends and SDOH factors can provide a more holistic picture and insights into these determinants can help healthcare organizations identify and address the needs of their communities more effectively.

For example, uncovering trends in mental health and telehealth utilization can inform resource allocation, service line provision, and strategic planning.

The data analyzed by LexisNexis Risk Solutions shows that while virtual mental healthcare utilization surged during the peak of the pandemic, there has been a notable shift back to in-office visits, particularly among children and teens.

This trend indicates the need for healthcare organizations to ensure they have adequate resources for both virtual and in-person care settings, with a particular focus on engaging with younger patients in person.

What Data Can Do

Digital health tools and claims analytics can provide critical insights into mental health and telehealth utilization trends before, during, and after the COVID-19 pandemic and can help healthcare organizations to:

1. Understand Utilization Trends: By analyzing data on mental health claims, organizations can identify trends in the utilization of mental health services. This includes understanding which conditions are seeing the most significant increases in claims and which populations are most affected.
2. Optimize Resource Allocation: With insights into where the demand for mental health services is greatest, healthcare organizations can allocate resources more effectively. This includes ensuring that there are enough providers to meet the demand and that resources are available in both virtual and in-person settings.
3. Improve Access to Care: By identifying barriers to care, such as lack of insurance or transportation, organizations can develop strategies to improve access to mental health services. This might include expanding telehealth services, offering transportation assistance, or providing financial support for low-income patients.
4. Enhance Patient Engagement: Understanding the needs and preferences of different patient populations can help organizations develop more effective engagement strategies. For example, knowing that children and teens are returning to in-office visits can inform efforts to enhance in-person care settings for these age groups.

Addressing the Growing Demand for Mental Healthcare

The data speaks for itself. The persistent demand for mental healthcare underscores the need for healthcare organizations to stay informed and responsive to the evolving needs of their communities.

By closely monitoring these trends and understanding the impact of social determinants of health, stakeholders can make data-driven decisions to allocate resources effectively and ensure that all patients receive the care they need.

Promoting Health Equity

Promoting health equity requires addressing the barriers that prevent marginalized populations from accessing mental health services. This includes expanding telehealth services to ensure they are accessible to all, regardless of socioeconomic status or geographic location. It also involves developing strategies to improve access to care for underserved communities, such as offering transportation assistance or financial support for low-income patients.

Enhancing Community Support

Building strong community support systems is essential for improving mental health outcomes. Healthcare organizations can work with community leaders and organizations to develop programs that provide social support, reduce stigma around mental health issues, and encourage individuals to seek care when needed.

The mental health crisis in the United States is a complex and persistent issue that requires ongoing attention and action. MarketView™ data provides valuable insights into the trends and disparities in mental healthcare utilization, which can help healthcare organizations better understand and address the needs of their populations.

By leveraging these insights and focusing on the social determinants of health, healthcare organizations can work towards achieving health equity and ensuring that all individuals have access to the mental healthcare they need.

About LexisNexis® Risk Solutions

The Healthcare Business of LexisNexis^® Risk Solutions harnesses the power of data, sophisticated analytics platforms and technology solutions to empower healthcare organizations with critical insights to transform operations and create healthier communities.

LexisNexis Risk Solutions is a sponsor of Healthcare Scene.