An imperfect perfect storm: The effects of deferred behavioral health care
We’re seeing light at the end of the tunnel as Americans start to get the COVID-19 vaccine. With it comes the hope that we can return to a life we once knew – a life of engaging with people – at work, at play and beyond.
Along with the renewed hope is a challenge for healthcare in general and behavioral health in particular: the effects of deferred care due to the pandemic. A recent survey revealed that 40 percent of individuals stated they canceled upcoming appointments, and an additional 12 percent stated they need care but haven’t scheduled an appointment. The situation complicates as we know that the pandemic has negatively affected individuals’ mental health and wellbeing. In another survey, 53 percent of American adults reported their mental health has been negatively affected due to COVID-19-related worry and stress.
In brief, we have a healthcare perfect storm: more people needing care who haven’t been getting it. The time is now for all healthcare players to work together to figure out how to stem the tide of deferred care.
The impact on the healthcare system
The effect of deferred care on the healthcare system is just becoming apparent, predicts McKinsey Consulting in a September 2020 article. Not only did the pandemic interrupt treatment for people with existing behavioral health challenges, it also has put more people at risk for developing behavioral health conditions, such as depression and substance use disorder (SUD). In fact, the article posits that approximately 35 million people could develop a behavioral health condition because of the pandemic.
This surge of behavioral health need will affect the healthcare system for many years. It will, of course, affect the quality of life for individuals needing behavioral health care, but some research indicates it will also increase costs: people with behavioral health challenges have approximately four times the healthcare spend of people without behavioral health conditions, according to the article.
It’s important to point out that medical care costs increase when someone has a behavioral health need. For example, individuals with no behavioral health condition incur approximately $2,400 in annual physical healthcare costs. Someone who has major depression spends on average $10,400 per year, with $1,800 of that on behavioral health care. For someone who has SUD, the average annual spend is $15,100, with only $1,700 of it for behavioral health services.
We can meet pent-up demand
As we prepare for the increased need, Beacon Health Options offers lessons learned during the pandemic to ensure access to care. The following Beacon efforts would apply to a post-pandemic world as well:
- Be proactive in identifying at-risk people through data analytics. Identifying at-risk people helps to connect these individuals to care before their conditions can escalate. To do so, Beacon invested in additional screening tools and made approximately 13,000 outreach calls.
- Promote telehealth and other virtual means of care. Not only did Beacon lift administrative requirements around telehealth, we also helped providers by offering many telehealth trainings. It turns out that there was an 80 times higher use of telehealth services among Beacon members in 2020 versus 2019.
- Increase the use of peer specialists. In addition to their normal duties, we trained peers to do outreach calls to at-risk members. We also trained them to facilitate online support groups. As the world shifts to a more virtual approach to healthcare, activities such as online support groups are likely to remain relevant.
- Pay attention to social determinants of health (SDoH). During our outreach calls, Beacon learned that 28 percent of people contacted had SDoH needs. Among other SDoH initiatives, we conducted provider-facing trainings on identifying and responding to SDoH and implemented an SDoH assessment tool.
These suggestions are a start. Beacon calls upon all stakeholders to determine what they can do at their organizations to ensure that people get care during these times when they need it more than ever.