May 20, 2019, US News: Young People Increasingly Represented in Growing Mental Health Insurance Claims--A new analysis underscores that depression and anxiety are growing problems for America’s youth. https://www.usnews.com/news/healthiest-communities/articles/2019-05-20/young-people-increasingly-represented-in-growing-mental-health-insurance-claims AMID GROWING CONCERN about the mental health of the nation’s young people, there is evidence that while behavioral health disorders – including both mental health and substance use disorders – have been increasing generally, children and young adults are bearing a heavy share of the burden. One study found that while the prevalence of major depression increased overall from 2005 to 2015, the rate of increase was faster in youth. Another found that more U.S. adolescents and young adults in the late 2010s, as compared with the mid-2000s, had serious psychological distress, depression and suicidal ideation, and more attempted or completed suicide – trends that were weaker among adults ages 26 and older. To aid the public discussion of these and other issues related to behavioral health, FAIR Health conducted a study of behavioral health trends and patterns in the privately insured population from 2007 to 2017. Analyzing information from our database of over 28 billion private health care claim records, we found that the pediatric population – defined here as ages 0 to 22, to include young adults of college age – was heavily represented in the increase in claim lines with mental health diagnoses. (“Claim lines” are the individual procedures or services listed on an insurance claim.) With May marking Mental Health Month in the U.S., here are some of our findings in detail. Overall Increase in Behavioral Health Claim Lines Among all ages, claim lines with behavioral health diagnoses – which include diagnoses of both mental health and substance abuse and dependence – increased in share 108%, rising from representing 1.3% of all medical claim lines in 2007 to 2.7% in 2017. Claim lines associated with mental health increased by 86%, from 1.2% to 2.3% of all medical claim lines. … Major depressive disorder (MDD) was the most common diagnosis in the distribution of claim lines with mental health diagnoses both in 2007, when it accounted for 28% of mental health claim lines, and 2017, when it accounted for 26%. Over that time, the proportion of MDD claim lines submitted for children and young adults grew from 15% in 2007 to 23% in 2017. Within the pediatric population, claim lines for MDD were most often submitted for individuals of high school age (ages 14 to 18) in 2007 and 2017. But these years also saw an increase in the share of claim lines for college-age individuals (ages 19 to 22), who went from accounting for 29% to 36% of total pediatric claim lines for MDD. Generalized Anxiety Disorder Generalized anxiety disorder (GAD) changed from the third- to the second-most common diagnosis in the distribution of mental health claim lines across all age groups between 2007 and 2017, rising from 12% to 22% of mental health claim lines. In fact, of mental health diagnoses accounting for more than 0.1% of all medical claim lines, GAD saw the greatest increase in claim lines over that time: These claim lines increased in share by 217%, accounting for 0.168% of all medical claim lines in 2007 to 0.523% in 2017…. Younger age groups also showed increases in GAD, as these claim lines for middle school-age children (ages 11 to 13) increased in share by 255%, shifting from 0.59% to 1.71% of all medical claim lines for the age group. GAD claim lines for elementary school-age children (ages 6 to 10) rose in share by 140%, increasing from 0.28% to 0.65% of all medical claim lines for that age group…. In 2017, in children 10 and under, boys accounted for more GAD claim lines than girls. In the middle school years, the distribution was weighted more toward girls, who accounted for 53% of total claim lines. …. Many potential causes for the increase in mental health issues among young people have been discussed, including growing academic pressures, school shootings and greater use of social media and smartphones. The increase in mental health claim lines may also be related to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 – which required parity in a plan’s coverage for behavioral health and medical-surgical treatment – and to the Affordable Care Act, which enabled young people to remain as dependents on their parents’ private insurance until age 26. Definitive answers are still lacking. In the meantime, we will continue to use our data resources to help shed light on varying aspects of behavioral health.
