While Americans may be ready to put COVID-19 in the rear view, new data show the mental health effects of the pandemic will be around for years to come.
Depression and anxiety jumped by more than 25% worldwide in 2020, according to a review of published studies. The global situation is vividly reflected in the United States, where 41% of Americans reported experiencing psychological challenges during the pandemic.
A System Under Strain
The wave of new cases is washing over a mental health care system that was struggling to meet patients’ needs even prior to the pandemic. Nearly 60% of U.S. counties lack a single psychiatrist, according to one report.
Eighteen months into the pandemic, primary care providers are overwhelmed and have, in many cases, nowhere to refer their patients who need more targeted mental health care. Some have urged for the declaration of a national mental health emergency.
The situation has become so dire in Massachusetts that the state has started releasing weekly updates on the number of patients in psychiatric crises who are “stuck” in emergency rooms because there’s nowhere for them to get care.
Insurers Resist Coverage
While the shortage of mental health providers and treatment centers are partially to blame for access issues, insurance barriers also contribute to the problem.
Insurers have resisted covering mental health treatment on the same level as other medical services, despite federal laws aimed at ensuring parity. And even people with insurance plans that cover mental health care don’t always get it straight away.
Instead, policies meant to limit health plan spending can delay or block coverage for mental health patients’ treatment. These tactics may include:
- Step therapy, which requires patients to try one or more insurer-preferred medications before gaining access to the one their health care provider prescribed. In some cases, patients spend weeks or months trying ineffective or suboptimal treatments. These can have “disastrous consequences” for people taking antidepressants or antipsychotics.
- Prior authorization, which forces health care providers to divert time from seeing patients to complete insurance company forms. In short, the process forces providers to justify why patients should get the medication they believe is most appropriate.
- Non-Medical Switching, which involves insurers directing patients to stop taking medications that work for them in favor of insurer-preferred drugs. Derailing treatment for non-medical reasons is inappropriate and can also be dangerous, particularly for mental health patients.
Brighter Days Ahead
Some states have already limited certain insurance company practices, and others are taking a closer look. At the federal level, the bipartisan Safe Step Act was introduced this year in both the House of Representatives and the Senate. And to help meet the immediate needs, $825 million in federal grants were provided to community mental health centers in September.
While these actions are helpful, what America needs most is a comprehensive approach to making mental health treatment more accessible and affordable. Without it, the mental health effects of COVID-19 could persist long after the pandemic.