Amid COVID-19 Pandemic, Many Americans Are Foregoing Mental Health Care

Aislinn Antrim, Associate Editor

Findings showed a 34% decrease in the number of mental health services utilized by children under age 19 and a 22% decline in the number of mental health services utilized by adults aged 19 to 64.

New data from the Centers for Medicare & Medicaid Services (CMS) show that many patients are foregoing mental health care during the COVID-19 pandemic, despite an increased need for many people caused by isolation and stress.

Investigators analyzed data from Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries regarding the utilization of health services. They found that between March and October 2020, patients skipped millions of primary, preventive, and mental health care visits due to the pandemic compared to the same period in 2019. Although utilization rates for some health care sectors have rebounded to pre-pandemic levels, a press release noted that mental health services are having the slowest rebound.

This decline in health care utilization is occurring simultaneously with worsening mental health conditions across the country. These gaps in mental health care could have significant long-term impacts on health outcomes, especially among minority groups who were hit especially hard by the COVID-19 pandemic.

“This new data provides a window into the impacts of the pandemic for marginalized communities—particularly children and other vulnerable people—and is critical as we work toward meeting the needs of those that rely on Medicaid and CHIP,” said CMS Acting Administrator Liz Richter, in the press release.

According to CMS, the findings showed a 34% decrease in the number of mental health services utilized by children under 19 years of age and a 22% decline in the number of mental health services utilized by adults 19 to 64 years of age. These findings equate to approximately 14 million fewer mental health services for children and approximately 12 million fewer mental health services for adults.

Similarly, the investigators found that substance use disorder service utilization fell by 3.6 million services (13%) compared to the same time period in 2019. They noted that there are some preliminary reports showing increased drug-related mortality due to the COVID-19 pandemic.

Notably, the findings do suggest that utilization rates for certain primary and preventive services for children under 19 years of age have recovered to pre-pandemic levels or have started to rebound in many regions of the country. Although this is encouraging, the investigators said millions of services still need to be delivered in order to make up for those missed between March and October 2020.

Preliminary data for 2020 show that there were 9% fewer childhood vaccinations for CHIP beneficiaries under 2 years of age, as well as 21% fewer child screening services and 39% fewer dental services among children under 19 years of age. These findings take into account increases in telehealth utilization of services via telehealth.

CMS officials encouraged use of telehealth options during the COVID-19 pandemic to increase access to care, according to the press release. The new data showed a significant increase in the number of services delivered via telehealth in 2020 compared to prior years, surging by 2700% during the pandemic. However, the researchers said this increase is not enough to offset the decline in service utilization in other health care sectors.

To help close these gaps in mental health care, CMS is emphasizing mental health in a new outreach program called the Connecting Kids to Coverage National Campaign. The program reaches out to families with children and teens eligible for Medicaid and CHIP, according to the press release.

“While we’re encouraged that people are accessing some health care services at pre-pandemic levels, there is work to do to connect people to mental health care services and to ensure we fill the gap in other types of services that was caused by the pandemic,” Richter concluded in the press release. “The Centers for Medicare & Medicaid Services is committed to connecting people and children to health care—including mental health care.”

REFERENCE

CMS Data Shows Vulnerable Americans Foregoing Mental Health Care During COVID-19 Pandemic [news release]. CMS; May 14, 2021. https://www.cms.gov/newsroom/press-releases/cms-data-shows-vulnerable-americans-forgoing-mental-health-care-during-covid-19-pandemic. Accessed May 20, 2021.