The COVID-19 the pandemic has had a significant impact on demand for pediatric mental healthcare services, as insurance claims for such conditions doubled in 2020, according to a new study.
Between March and April 2020, total mental health claims for children ages 13 and 18 doubled compared to 2019, according to an analysis released Tuesday by the not-for-profit, transparency advocacy group FAIR Health.
During the same period, use of healthcare services for physical conditions declined by more than 50% compared to the same period of 2019 due to widespread restrictions on non-emergency medical care as well as ongoing patient hesitancy to access care even after restrictions were relaxed.
Robin Gelburd, president of FAIR Health, said the report's findings were both concerning and encouraging. Mental health conditions steadily made up more visits to the emergency department in 2020, accounting for 23% of all visits in September.
Other insurance claims also saw spikes. Claims for care to address intentional self harm by teenagers in the northeast increased by more than 300% in August 2020 compared to August 2019. Drug overdose and substance use disorder claims also rose sharply among teenagers in 2020, with overdose claims doubling in March and April compared to the previous year and substance use disorder claims rising by 65% in March and 63% in April, the report found.
But Gelburd said she was encouraged by patients' ability to quickly adopt telehealth services for mental healthcare services. Telehealth visits made up less than 10% of mental healthcare services in February 2020 among patients ages 19 to 22 compared to more than 90% of visits being conducted in person. By November, more than 70% of mental healthcare services were being performed through telehealth compared to less than 30% conducted through in-person office visits.
"That just shows an incredible response in that the patient community was resourceful in continuing to seek out the services they felt they needed during this period," Gelburd said.
Among younger children between ages six and 12, claims for obsessive-compulsive disorder and tic disorders increased beginning in spring through November of 2020 compared to the same period in 2019.
The report analyzed data from more than 32 billion private healthcare claim records between January and November of 2020 from patients between the ages of 0 and 22 years. Among the behavioral health topics examined included children's overall mental health, acts of intentional self-harm, overdoses and substance use disorders, top mental health diagnoses, and reasons for emergency room visits.
The findings reflect mounting evidence that the pandemic is causing a huge demand for behavioral healthcare services among children, which in turn is putting further stress on a system where one in six kids between the ages of 6 and 17 has a treatable mental health disorder yet only around half receive treatment.
Dr. Gregory Young, a psychologist at pediatric health system, Franciscan Children's, in Brighton, Massachusetts, said the higher rates of depression and anxiety he's seen among his young patients due to a lack of social contact for months has him worried about how well children will adapt to coming back to school if their feelings about the past year are not addressed or even recognized.
"I think the biggest concern is the unknown of how people are going to respond to this," Young said.
While tools like telehealth and tele-psychiatry have helped to meet some of the need for mental healthcare services during the pandemic,experts fear the country is headed for a new crisis that will see an influx of children seeking care for behavioral healthcare conditions that were left untreated, unmanaged and undiagnosed for months.
Between April and October 2020, mental health–related visits within pediatric emergency departments rose by approximately 24% among children ages 5 to 11 and 31% for kids ages 12 to 17 compared to the same months during 2019, according to the Centers for Disease Control and Prevention.