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Young People Using More Mental Health Services, Analysis of 28B Records Shows


People between the ages of zero and 22 years old had more claim lines linked with depression and anxiety disorders.

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Patients 22 years old and younger were disproportionately represented in the increase in services and procedures listed on insurance claims associated with mental health diagnoses between 2007 and 2017, according to an analysis of billions of claims records.

The analysis from FAIR Health, “Spotlight on National Behavioral Health Trends,” revealed that the share of services for major depressive disorder in that population increased from 15 to 23%. Major depressive disorder was the most common mental health diagnosis.

FAIR Health used data from its database of more than 28 billion private healthcare claim records, which it said is the largest in the country. The company used the data to analyze behavioral health trends and patterns over a 10-year period.

Generalized anxiety disorder services rose the most for individuals aged 19 to 22 years old and 14 to 18 years old. Over 10 years, services and procedures linked with major depressive disorder and generalized anxiety disorder became more common by comparison to claim lines for all medical diagnoses in most of the country, except the south.

Lines for young adults aged 19-30 with adjustment disorders increased 78%.

From 2007 to 2017, claim lines with behavioral health diagnoses increased 108%, rising from 1.3% to 2.7%.

“Our study provides a strong foundation of key indicators of behavioral health services among the privately insured,” said Robin Gelburd, president of FAIR Health.

The years 2007 through 2017 represent the time period before and after the passing of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. The act requires a plan’s coverage for behavioral health treatment to be equal with its coverage for medical-surgical treatment.

FAIR Health used the International Classification of Diseases diagnostic codes on claims indicative of a mental health condition and substance use, abuse or dependence. The company evaluated the data by stratifying patients by gender, age, type of condition and the state where the service took place.

Using the data, researchers found that opioid dependence services increased 1,180% from 2007 to 2017, but that figure fell 50% from 2015 to 2017.

Dependence on stimulants other than cocaine saw the greatest increase in insurance claims (3,490%) from any other substance use disorder, even though it made up a small percentage of all medical claim lines.

“In a time of change in the nation’s behavioral health, the trends and patterns revealed in this study have implications for numerous stakeholders, including providers, payers, researchers, policy makers and patients,” researchers noted.

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