Mental Health Diagnoses Take Unprecedented Leap

Clinical relevance: Mental health diagnoses in the US increased by nearly 40% between 2019 and 2023.

The rise is attributed to shifting societal attitudes and improved access to care.
Generalized anxiety disorder and ADHD were the most common diagnoses in 2023.
Concerns about the burden on primary care physicians and calls for enhanced collaboration with mental health specialists have been raised.

As everyone navigates their way out from under the long shadow of the pandemic – and a younger generation ignores the historical stigma – a new survey finds that mental health diagnoses jumped nearly 40 percent over the last half-decade.

The research, which FAIR Health Inc. published in a white paper, reports that, in the United States, the share of patients with mental health diagnoses rose 39.8 percent between 2019 and 2023 – from 13.5 percent of medical patients to 18.9 percent in 2023.

“The findings in this report have implications for stakeholders across the healthcare spectrum, including patients with mental health conditions and the providers who treat them, as well as payors and policymakers,” FAIR Health President Robin Gelburd stated. “We hope these findings will also be starting points for further research on mental health conditions.”

FAIR Health, a New York City-based nonprofit committed to health care and health insurance transparency, mined its database of more than 46 billion private claims. The researchers focused on mental health service utilization trends, “including such aspects as geography, age, gender, in-network services, places of service, specialties, and the prevalence of substance use disorders among those with mental health conditions.”

Claims on the Rise

“Last year, we saw nearly 500% growth in our clinic and we’ve seen a similar pattern to the findings,” Axis Integrated Mental Health CEO Christopher Perez said. “We’ve also seen an increase in both children and seniors.

But, Perez added, the trend didn’t come out of nowhere. And he’s pretty sure what’s driving it.

“It’s crucial to recognize that this increase isn’t necessarily indicative of a sudden surge in mental health issues, but rather a positive shift in societal attitudes towards seeking help and destigmatizing mental health conditions,” Perez explained. “In addition to this shift, the mental health parity law changes have increased the ability of patients to see mental health providers without a referral, which have enabled patients to quickly get diagnosed and get help from mental health specialists, rather than having to see a primary care physician first.”

Across the board, the nonprofit found that generalized anxiety disorder appeared more than any other diagnosis in 2023. However, attention-deficit/hyperactivity disorder (ADHD) surged ahead as the leading disorder among the 13 and younger set.

A Deeper Dive into the Numbers

The most common diagnoses in 2023— following generalized anxiety disorder — were:

Major depressive disorder.
ADHD.
Adjustment disorders.
Bipolar disorder.

All five categories saw a rise in patient claims during the survey period, with ADHD experiencing the biggest surge at more than 70 percent.

Other findings include:

The Midwest boasted the largest growth in the percentage of patients with diagnoses during the study period – at 47 percent – as well as the largest percentage of patients in 2023 with 21.3 percent.
The percentage of patients with mental health diagnoses increased across all demographics, but the increase fluctuated according to age group. Older Americans (aged 60 and over) powered the largest spike – 57.4 percent.
Women made up a higher percentage of patients than men did in all except the youngest patients (those younger than 13). Though the percentage of both male and female patients grew, women showed a larger increase: 44.6 percent, compared to 32.7 percent for men.

While care providers find numbers like these encouraging, others are concerned about who’s carrying the weight of the load.

“While 79% of antidepressants are prescribed by primary care physicians, it’s unfair that they should be the ones to shoulder the responsibility of managing complex mental health conditions alone,” Perez pointed out. “These statistics show why it’s crucial to expand access to mental health care and improve the collaboration between physicians and mental health specialists to not only deal with the surge in demand but also, to provide access to newer and more effective treatments like Spravato and TMS.”