COVID-19 drives behavioral health demand; insurers play pivotal role in ensuring access

As the COVID-19 pandemic persists, medical experts across the country predict a continuing, significant need for mental health and substance abuse treatments. Even for those who have not historically used behavioral health resources, stressors from the pandemic such as quarantine, isolation, anxiety over financial/job security, and other concerns, are expected to increase demand.

As of July 2020, the Centers for Disease Control and Prevention estimates that 41% of people have experienced symptoms of an anxiety or depressive disorder as a result of the pandemic. A medical study from June 2020 reported a 47% increase in crisis calls to national crisis hotlines, with some experiencing a 300% increase in call volume. Also, in the past several months, there has been a significant increase in prescriptions for anti-anxiety and antidepressant medications, with the majority being first-time prescriptions. Meanwhile, among people with substance use disorders, a recent survey found a 20% increase in substance use since the pandemic began.

All of this is to say that our nation’s behavioral health delivery system is being stressed. In the wake of the economic downturn caused by the pandemic, organizational and state-supported behavioral health programs like mental health help lines and support groups have had their budgets cut or discontinued entirely. This has left many to rely solely on primary-care providers for behavioral health, and those providers have faced their own unique challenges with operating budgets and telehealth capabilities.

As the largest Medicaid managed-care organization in the country supporting some of the most at-risk individuals, Centene is committed to finding innovative ways to address community needs. During this unprecedented time, it is important to share ideas throughout the industry to increase awareness and access to behavioral health support and tools for both members and healthcare providers. There are several ways for payers to promote behavioral health prevention, screening, education and treatment access—especially among vulnerable populations.

Prevention is essential, and it’s important to emphasize self-care such as exercise, healthy eating and virtual and safe social interactions when communicating with members. It’s also critical to include behavioral health screening and suicide prevention safety planning as part of managing physical health conditions. Increasing education and awareness, and promoting anti-stigma messages for both providers and members can go a long way to help normalize the difficulties that many are experiencing.

Behavioral health screenings are integral to addressing a member’s overall health during this challenging time. Culturally sensitive screening programs help at-risk populations with unique needs or those who have already experienced health disparities. Healthcare payers can also offer training for staff and community members to help them identify signs of mental health distress, and equip providers with evidence-informed suicide intervention tools and trainings such as the Suicide Safe App from the Substance Abuse and Mental Health Services Administration.

To support access to care, provider networks should include both in-person care and telehealth treatment. Healthcare organizations should be encouraged to bolster infrastructure to make telehealth more accessible, exploring alternative services such as audio-only options, which help overcome inadequate access to technology that can drive health disparities.

Payers can also ease or waive authorizations and cost-sharing requirements to increase access to behavioral health services, such as treatment and recovery needs for members who have, or are at the highest risk for, opioid use disorder. Health plans can also look beyond traditional provider-patient channels by supporting and promoting crisis lines to ensure members are aware of the help that’s available.

Much is still being uncovered about the short- and long-term effects of COVID-19 to both physical and mental health. During this pandemic, it’s critical that health insurers are adapting to members’ evolving needs and helping to ensure adequate resources are available.