Ingram's April 2024

The Pandemic Was a Nightmare. So Is the Mental-Health Impact. Early data validate the fears that the impact of COVID-19 will not be limited to its physical toll.

by Dennis Boone

The global pandemic swept the Unit ed States in early 2020, but took a while to exert its worst aspects on the Midwest and the Kansas City area. One aspect of it, though, was almost immediate: In the interest of public safe ty and limiting the number of cases of COVID-19, area hospitals, medical cen- ters, clinics and private practices all but shut down elective surgeries, only a small number of which were truly elec tive in the cosmetic sense. They could be deferred, but with potential conse quences short of life-threatening. The public, however, went a step fur ther, canceling visits to health providers for chronic conditions that needed to be monitored and treated. The big unknown at the time was: How many illnesses ar en’t being addressed, which types, and what will delayed treatment translate into with the financial costs of care? While the providers are starting to get a better sense of the damage done, there’s still much unknown to insurers and brokers about the long-term conse quences of decisions that, in retrospect, were probably misguided. As it turns out, the vast majority of Americans, vaccinat ed or not, ended up catching a form of the virus as it evolved—nearly 80 per cent within the first two years, accord ing to the Centers for Disease Control and Prevention. The first signs of population health impact, however, are starting to emerge. And it’s not where you might initially ex pect—it’s on the mental health side. The impact of the pandemic wasn’t just the physical toll on people and the risk to the health of those with co-mor- bidities. Millions of Americans were thrown into a state of stress they had never experienced, thanks to millions of imme diate layoffs during economic shutdowns,

school closings, business failures, gener al anxiety, and depression. The number of suicides skyrocketed. The metrics for those have ebbed a bit since 2022 but are still above pre-pandemic levels. Regionally, Holmes Murphy & As sociates has compiled preliminary data that reflects the depth of the challenge, if not its financial costs. “We know mental and behavioral health needs skyrocketed during COVID,” says Matt Wheeler, the firm’s vice president for client services. For every 1,000 mem bers with medical claims, he said, “the prevalence of members accessing men tal health services on the medical plan grew by 23.5 percent,” increasing from 156 to 193 per thousand. The broader data on mental health claims also reflects the sharp increases. Whereas the firm saw 233,817 claims produced by a pool of 36,400 claim ants before the pandemic, the numbers soared 32 percent for claimants and an alarming 55.4 percent for distinct men tal health claims. Part of that surge includes claims filed on behalf of minors. In addition to the fear of the unknown with the poten tial lethality of the pandemic—which we now know was a far greater threat to those with co-morbidities, the over weight and people over 65—school-age children were stressed by the loss of their classroom routines, disrupted stud ies, and alienation from social networks. Earlier this year, researchers from Johns Hopkins Children’s Center in Maryland published the results of their investigation into the effects of the pandemic on preexisting mental health disparities among youth. Their conclu sions? In addition to the pandemic-relat ed increases, the subject group suffered significantly higher rates of depression,

anxiety, and suicidal thoughts since the onset of the pandemic. And those elevat ed levels are still presenting themselves. “Our findings show this is a real problem that we need to urgently ad dress on all fronts,” says Laura Prichett, the study’s lead author. “It is clear that these past few years have significantly impacted young people’s mental health. This is a serious problem, and we need to take urgent action.” On a broader level, Mental Health America’s 2023 report on the state of the nation’s mental health showed that:  21 percent of adults—roughly 50 million people—are experiencing at least one mental illness.  Worse, 55 percent of adults with a mental illness have not received any treatment.  For 5.44 percent of adults, their cases fall into the “severe” category.  More than 12.1 million adults have seriously considered suicide. Topping the list of states with the highest percentages of people consider ing suicide was Kansas. While national figures are improv ing somewhat, the National Center for Health Statistics reports that 40 percent of Americans said they had experienced symptoms of anxiety and depression in 2020—up more than 350 percent from the pre-pandemic year of 2019. Given the mental health challenges, it’s no surprise that the nation has seen a spike in substance abuse disorders. Mil lions of Americans turned to alcohol and drugs to cope with the pandemic itself or the consequences of missed medi cal treatment: 11 percent of adults said they had abused alcohol; 6.82 percent turned to illicit drugs, contributing to more than 93,000 overdose deaths nationwide in 2020 alone.

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April 2024