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Video call with doctorA new study published in JAMA Health Forum shows that US spending on mental health services rose 53% from March 2020 to August 2022, according to claims of almost 7 million commercially insured adults from January 2019 through August 2022.

To conduct the study, researchers looked at health insurance claims during three study periods: immediately before the pandemic (January 1, 2019, through March 12, 2020), during the acute phase of the pandemic before vaccines were available (March 13, 2020, through December 17, 2020), and after vaccines were widely available (December of 2020 through August of 2022).

The researchers looked at claim and diagnostic codes for anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia, and posttraumatic stress disorder. A total of 1,554,895 mental health service claims were analyzed.

Large transition to telehealth

Unlike physical health concerns, mental health care transitioned to telehealth during the acute and continued phase of the pandemic.

"During the acute phase, in-person visits decreased by 39.5% and telehealth visits increased more than 10-fold (1,019.3%) compared with the year prior," the authors wrote. "Jointly, this represented a 22.3% increase in overall utilization. These trends were generally consistent across conditions."

The changes that occurred during the COVID-19 pandemic have triggered a significant expansion in the use of mental health services.

During the post-acute phase of the pandemic, telehealth visits remained more than 10 times (1,068.3%) that of prepandemic levels, and in-person visits increased 2.2% each month over the period. By August 2022, the authors write, in-person visits had returned to 79.9% of prepandemic levels; overall mental health service use was 38.8% higher than before the pandemic.

"The changes that occurred during the COVID-19 pandemic have triggered a significant expansion in the use of mental health services among adults with employer-based health insurance," said Jonathan Cantor, PhD, lead author of the study and a policy researcher at RAND, in a RAND Corporation press release. "It remains uncertain whether this trend will continue or return to levels similar to those seen before the pandemic."

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