Substance use disorders and mental health affect about 13% of the worlds population. Amidst the coronavirus pandemic, when people had to remain at home and adjust to this new normal, this number might have increased. According to a survey conducted by Singlecare on coronavirus and mental health, it was found that almost 59% of the United States populations mental health was affected because of the pandemic. That is why it is crucial to dismantle the stigma surrounding mental illness. In this article, you will learn about what mental health is and mental disorder statistics for the US in 2021:
What is mental illness?
There are two categories of mental illness – the first one is serious mental illness (SMI) and the second one is any mental illness (AMI). However, these two are not always mutually exclusive. According to the Substance Abuse and Mental Health Services Association (SAMHSA), AMI is defined as having a mental, behavioral, or emotional health disorder that meets the criteria set by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). SMI occurs when a person with an AMI gets one or more important life activities limited or interfered with because of their disorder. Here are some of the common health conditions:
- Anxiety – Anxiety disorder can be characterized by persistent stress, fear, and worry to an extent that it interferes with the persons everyday life.
- Depression – Persistent fatigue, low mood, and profound sadness are some of the symptoms of depression.
- Bipolar disorder – This condition involves radical shifts in low or depressive moods and high or manic moods that last for weeks.
- Substance use disorders – This condition can cause a person to use alcohol or drugs so frequently that it interferes with the persons day-to-day life.
- Schizophrenia – Schizophrenia is a severe and chronic mental disorder affecting the feelings, behaviors, and thoughts of a person.
- Obsessive-compulsive disorder (OCD) – This is a long-lasting, chronic anxiety disorder that causes recurring, uncontrollable, and unreasonable thoughts in a person that are followed by the behavioral response.
- Post-traumatic stress disorder (PTSD) – This disorder develops in someone who has experienced a dangerous or shocking event and is facing difficulty recovering from that trauma.
- Eating disorders – These illnesses can affect someones relationship with food and their body image.
It is important to gather information on mental order as the data helps in measuring the mental health of the society, access to care, and the outcomes. The data helps in getting the information regardless of the differences between the mental health policies of different states. Also, ranking can help explore the states that are better at addressing substance use and mental health issues.
Mental Health before COVID-19
It is important to stay committed to improving the situation of mental health and promoting it as a part of overall wellness. People need to advocate for prevention services, early identification and intervention, integrated services, and treatment and care for those who need them. According to the research conducted by Mental Health America (MHA), the youth mental health in the United States is worsening. Compared to the 9.2% of 2020s dataset, about 9.7% of the youth is suffering from severe major depression. This number was highest, at 12.4%, among youth identifying as more than one race.
Even before the pandemic hit the United States, mental illness was quite prevalent among adults and the number of affected people was continuously increasing. About 19% of adults had a mental illness in 2017-2018. Apart from this, suicidal ideation among adults has also been on the rise. From 2016 to 2017, the percentage of adults living in the United States who experienced serious suicidal thoughts increased by 0.15%. This was an additional 460,000 people from the previous years dataset. This data shows that there is an immediate need for treatment for mental illnesses among adults and youth. In 2017-2018, about 60% of the American youth who had major depression did not get any treatment. Even in states that have better access, more than 38% of youth didnt receive the mental health treatment they needed. Out of all the youth suffering from severe depression, only 27.3% receive consistent treatment. During the same period, 23.6% of adults suffering from some form of mental illness reported the need for treatment that was unmet. The number has been increasing since 2011. Since the Affordable Care Act (ACA) was passed, the percentage of adults who have mental illness and are uninsured increased for the very first time. The national percentage is 10.8% which is about 5.1 million adults. However, this figure dramatically differs across states. New Jersey is on the top of the list where only 2.5% of adults who have AMI are uninsured. The last state on the list was Wyoming with 23% uninsured adults with AMI.
COVID-19 and mental health
Another report published by Mental Health America (MHA) showed how COVID-19 had an impact on mental health. The data was collected using more than 1.5 million people who took a screen on MHA screening between January and September 2020. The report showed that the number of people who are looking for help with their anxiety and depression has drastically increased. During the given time period, about 315,220 people had taken the anxiety screen which is a 93% increase from 2019s number of anxiety screens. The number of people who had taken the depression screen is 534,784 which is about a 62% increase from 2019s number of depression screens.
The report also showed that the number of people who were screened with moderate or severe symptoms of anxiety and depression increased continuously throughout 2020 and remains a lot higher than rates before the pandemic. In September 2020, about 8 out of 10 people who took the anxiety screen scored moderate to severe symptoms which is the peak rate. Over 8 out of 10 people who had taken the depression screen scored with moderate to severe depression symptoms consistently since the pandemic began in March 2020. Also, more and more people are reporting having frequent self-harm and suicidal thoughts.
In fact, since the MHA Screening program was launched in 2014, the number has never been this high. Since the pandemic started spreading rapidly in 2020, more than 178,000 people reported having suicidal ideation frequently. About 37% of people reported having suicidal thoughts more than half or every day in the month of September 2020.
Young people are the ones who have been struggling the most with their mental health. In the youth aged between 11 to 17 years who assessed screening, the proportion was 9% higher than 2019s average. The number of youth who are searching for help or treatment with their mental health is increasing. Also, throughout the pandemic, youth between the age of 11 and 17 years were more likely to score for symptoms of depression and anxiety than other age groups. The suicidal ideation rates are also the highest among youth, particularly the LGBTQ+ youth. Over half of the youth of the above-mentioned age group were reported having self-harm or suicidal thoughts for more than half or almost every day in September 2020. Between January and September, 77,470 youth reported having suicidal ideation frequently, out of which 27,980 were from the LGBTQ+ community.
People who are screening at risk for mental illnesses are mostly struggling with isolation and loneliness. Between April and September 2020, out of all the people who screened with symptoms of anxiety and depression, about 70% reported that one of the main things that contributed to their mental illness was isolation or loneliness. Also, in 2020, people who identified themselves as Pacific Islanders or Asians were searching for resources for their mental health more than ever.
The percentage of such screeners increased from 9% in 2019 to 16% in 2020. And even though rates of suicidal ideation, depression, and anxiety are increasing among people of all ethnicities and races, there are some notable differences in the changes over time. For example, African American or Black screeners have the highest average percentage of change over time for depression and anxiety and American Indian or Native American screeners have the highest average percentage of change over time for suicide and self-harm thoughts.
Mental health treatment
It is important to note that medical coverage for mental health is as important as coverage for physical health. According to the Affordable Care Act (ACA) that was enacted in 2010, all plans that are sold on the family and individual health insurance marketplace have to offer mental health insurance coverage. Taking care of ones mental health is important, especially during a pandemic.
Depending on the mental disorder, the mental health treatment will differ. People who are looking for treatment need to consult a mental health professional and discuss the medications and therapies that might work for them. Treatment in the US can be expansive with the costs of medication and therapy scaling thousands of dollars. Lancet Psychiatry published a study that states that by 2030, the total cost of depression and anxiety disorders across 36 countries is expected to be $147 billion. This huge cost will lead to a net benefit, based on the modest 5% improvement in work productivity that will result in an economic gain of $399 billion.
As per the healthcare.gov, all marketplace health insurance plans offer coverage for substance abuse and mental health services including counseling, substance use disorder treatment, inpatient services, and psychotherapy. Also, Marketplace plans dont have the authority to deny coverage for a pre-existing mental health condition.
Medicaid is the largest payer of mental health services in the country. When it comes to Medicare coverage, Medicare Part A will cover hospitalizations and admissions because of mental health problems whereas Medicare B will cover mental health visits. The ACA was enabled with the goal of ensuring that healthcare is affordable to Americans. The plans that comply with ACA will cover mental health care along with maternity care and preventative services. This means that people who have enrolled in an ACA-compliant plan will have access to mental health coverage. Most of the employer-sponsored plans include mental health services as well under the ACA. According to ACA, all insurance companies have to cap out-of-pocket spending of the customers. Also, the limit on lifetime or annual coverage for mental health care has been prohibited. These steps will ensure that mental insurance is affordable for American citizens.
Before the ACA was enacted, family and individual health insurance plans didnt have to cover mental health care. In fact, people were denied coverage on the basis of pre-existing conditions that included mental health conditions such as depression. People who had pre-existing conditions had difficulty in finding insurance coverage for their mental healthcare at an affordable rate. Many were even denied coverage.
With the ACA-compliant plans, mental health insurance coverage is offered as an essential benefit. The health insurance plan will cover a part of ones cost for mental illness treatment, just like it would for any other physical condition. If someones plan is denying them mental health insurance coverage, they can talk to the plan provider or even write a formal appeal. As per ACA, all plans have to cover the following services associated with mental health treatment:
- Behavioral treatment (counseling and psychotherapy) that includes:
- Group therapy sessions or outpatient individual counseling
- Diagnostic services like psychological evaluation and testing services
- Ongoing treatment that includes medication management therapy and psychiatry treatment programs
- Substance use disorder treatment that includes:
- Diagnostic and treatment services for chemical or alcohol dependency
- Substance abuse recovery services such as educational resources and counseling
- Medical services for symptoms of withdrawal like inpatient detoxification services
- Behavioral and mental health inpatient services
- Inpatient mental health care for when someone is admitted to a psychiatric facility
The Milliman firm published a report in 2019 that states that compared to a primary care appointment, a visit to the therapists office is seven to 11.5 times more likely to be out of network. If someone is using mental health services frequently, they should go for a plan that offers lower out-of-network costs like a PPO plan. This will allow them to see providers who are out of their network while still maintaining coverage for the services.
During the pandemic, it has become more important to take care of ones mental health. Social distancing has made people feel isolated and they need more support than ever. If someone is feeling anxious, overwhelmed, or stressed and noticing changes in their alcohol consumption, sleeping, or eating, it is crucial that they talk with a health professional and take care of their mental health.