Access to mental health services dwindled as pandemic need strained providers: GAO report

Access to mental health services dwindled as providers were strained and under the demand for care during the COVID-19 pandemic, according to a Government Accountability Office (GAO) report made public on Friday. 

The GAO concluded that the number of people experiencing anxiety, depression and drug overdoses heightened during the pandemic, while mental health professionals dealt with layoffs, decreased hours and having to turn away patients. 

Respondents to Centers for Disease Control and Prevention (CDC) surveys determined that about 38 percent reported symptoms of anxiety or depression between April 2020 and February 2021. Eleven percent said the same in 2019. 

Similarly, emergency departments saw 36 percent more visits for overdoses and 26 percent more visits for suicide attempts from mid-March to mid-October of last year, compared to the previous year. 

At the same time, the National Council for Behavioral Health (NCBH) surveyed its members in February 2021 and found that in the three months before the survey, about two-thirds of member organizations saw an escalation in demand, leading them to have to cancel or reschedule appointments or turn patients away.  

The report also cited federal data that showed that there were not enough mental health professionals available, and this contributed to the lack of access, particularly in rural areas.

The NCBH survey found 45 percent of member organizations closed some programs, 35 percent reduced staff hours, 27 percent laid off employees and 23 percent furloughed employees. 

The GAO said other factors contributing to the lack of access included provider reimbursement rates and health system capacity, citing interviews of stakeholders including officials from NCBH and hospital associations and insurance regulators in Oregon, Pennsylvania, Texas and Virginia. 

Most provider groups interviewed reported more issues with payment through Medicaid than other payers, according to the report. 

The office said there was not currently data showing insurers violated mental health parity law, although interviewees presented anecdotal examples. The law prevents companies from charging patients more for mental health care than they would for medical or surgical care.

Kaiser Health News first reported on the GAO report. 

Senate Finance Committee Chairman Ron Wyden (D-Ore.) had requested in May 2020 that the GAO research mental health access and the pandemic’s effects on mental health, a request that resulted in this report. 

“Underlying the global pandemic is a five-alarm fire when it comes to the state of Americans’ mental health,” Wyden said in a statement. “The pandemic has made access to mental health care more urgent than ever while worsening long-standing shortcomings in the system.”

“Mental health and physical health ought to be on the same footing in America’s health care system, and I will be using my position as Chairman of the Finance Committee to make that a reality,” he added.