Mental health services struggled to meet demand during pandemic, study finds

Anxiety, depression, and emergency department visits for drug overdoses and suicide attempts all rose during the pandemic — all while behavioral health services in the past year struggled to meet increased demand, according to a study released Friday by the U.S. Government Accountability Office.

The study analyzed data from the Centers for Disease Control and Prevention that found that 27% more adults in the U.S. reported symptoms of anxiety or depression during the pandemic, between April 2020 and February 2021, compared to in 2019. ER visits for drug overdoses increased by 36% and ER visits for suicide attempts rose by 26% in the past year compared to the same time period of the year earlier. 

But more than half of behavioral health services reported that they had to cancel, reschedule patient appointments or turn people away from services during late 2020 and early 2021, according to a survey cited in the GAO report and conducted by the National Council for Behavioral Health, an advocacy association for mental health. Organizations reported program closures, shortened hours of operations, and employee layoffs, the survey found. 

And shortages aren’t predicted to stop, the study said. The Health Resources and Services Administration predicted that by 2025, seven types of mental health providers such as social workers and therapists, could face major shortages.

According to the GAO report, stakeholders told researchers that struggles to meet demand had been a “longstanding problem” and attributed shortages to a lack of employees, medical provider reimbursement rates and health system capacity. In 2013, an estimated 3.9 million adults with serious mental illnesses reported unmet needs for mental health care, according to the Substance Abuse and Mental Health Services Administration. 

The study found that issues with availability particularly impacted those in rural areas and patients using Medicaid, potentially due to shortages of qualified health professionals in the area and routine denials for Medicaid payment in behavioral health service treatment, the report said. The Health Resources and Services Administration found in September 2020 that more than one-third of Americans lived in designated mental health provider shortage areas. 

Senator Ron Wyden, ranking member of the Senate Finance Committee, asked the Government Accountability Office in May of last year to conduct the study to ensure that insurance plans covering mental health services were meeting their legal requirements and covering care for those who need it.

Wyden said at the time, “The COVID-19 pandemic has exposed shortfalls across the health care system, and mental health care is no exception.”