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HRI survey: More Americans with mental health diagnosis reporting trouble with social determinants

Lisa LaMotta Editor-in-Chief, Risk and Regulatory, PwC US April 30, 2020

Surveyed before and after the pandemic struck, US consumers polled by HRI were more likely to report feelings of isolation or loneliness, a sense that they are spending too much time on technology and a lack of access to healthy food and a safe place to exercise. 

Sixty-one percent of US consumers responding to HRI’s pandemic survey reported that they have been affected negatively in at least one social or environmental area, such as sleep, affordable housing or childcare. This is especially true for Americans with a primary mental health diagnosis. Seventy-six percent of these consumers said they were struggling with at least one social determinant of health. Surveyed before the pandemic, just over half of consumers said they were experiencing challenges with one or more social determinants of health.

With the upending of American life due to COVID-19 likely has come a deterioration in many Americans’ mental health. A recent report from a national pharmacy benefit manager (PBM) showed that prescriptions for anti-anxiety medications, antidepressants and insomnia drugs increased 21% between Feb. 16 and March 15, with prescriptions peaking the last week of the period—the same week that the World Health Organization declared a pandemic and the US declared a national state of emergency. 

Prescriptions filled for anti-anxiety medicines increased the most, jumping 34.1% during the monthlong period. According to the data, women were more likely to fill anti-anxiety prescriptions than men.

Meanwhile, antidepressant scripts increased 18.6% and sleep disorder drugs by 14.8% during the month before stay-at-home orders began. The use of antidepressants had been on the rise over the previous five years, climbing 15%, according to the report.

One in five US adults is affected by mental illness; one in 25 adults experience serious mental illness, according to the National Alliance on Mental Illness (NAMI). Mental health conditions often lead to other serious issues, including substance abuse, and those with serious mental illness are also at a higher risk of chronic disease.

HRI impact analysis

Before the pandemic, HRI’s Medical Cost Trend: Behind the Numbers 2020 report found that employers had started to recognize the importance of helping their employees manage their mental health and well-being. PwC’s Health and Well-being Touchstone survey revealed that 75% of employers offered disease management programs focused on depression and mental health in 2018, up from 34% in 2014.

But the supply of mental health practitioners remains a challenge: 21% of consumers surveyed by HRI with employer-based insurance who have sought treatment for a mental or behavioral health issue in the past five years said it was difficult to find a mental health professional accepting new patients for the services they required, according to HRI’s spring 2019 consumer survey.

During the pandemic, telehealth is an option, but many patients may fall through the cracks during the crisis. Healthcare providers and payers will be challenged to respond to heightening mental health needs by addressing care gaps and planning for increased needs in a post-pandemic world.

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