Research Reveals Disconnect Between Increased Stress and Lower Diagnoses Rates in Virginia

Pandemic leads to decrease in mental healthcare over 2020 calendar year for children and older adults in Virginia, says State of the Nation’s Mental Health report

RICHMOND, Va.--()--While people in America have shared that the pandemic and other stressors like social injustice, elections, and the economy negatively impacted their mental health in 2020, there wasn’t a corresponding increase in people seeking mental health treatment, according to the inaugural State of the Nation’s Mental Health report, commissioned by Anthem, Inc., parent company to Anthem Blue Cross and Blue Shield in Virginia (Anthem).

Children and older adults in Virginia appeared to have the largest overall downturn, reporting significantly fewer mental health diagnoses in 2020 compared to 2019. Younger adults, meanwhile, had a smaller than expected increase in mental health diagnoses for the full year of 2020. However, diagnoses and treatment for anxiety and PTSD for adults were among the few mental health diagnoses that grew in 2020.

“According to our data, many Virginians who may benefit from mental health services, especially children and older adults, are either not being identified or not reaching out for help,” said Maureen Dempsey, M.D. Anthem Blue Cross and Blue Shield in Virginia’s senior clinical officer. “This should be a call to action for all of us. Social isolation, financial insecurity and balancing work at home with home schooling remain a concern as the pandemic stretches into its second year. Mitigating the effects of these stressors via early identification and timely intervention is as crucial as to our overall health as assuring that everyone has access to life saving COVID 19 vaccines. That is why we continue to focus on the physical and mental well-being of our members and communities.”

These findings, part of a new State of the Nation’s Mental Health report based on Anthem Blue Cross and Blue Shield-affiliated health plan claims from more than 2 million Virginians, show the pandemic disconnect between feeling stressed and depressed and being diagnosed and seeking treatment.

Recent studies have shown that many more adults reported symptoms of anxiety or depression. Further, 42 percent of people under 30 years old were experiencing anxiety and depression symptoms, according to a CDC survey from August 2020 through February 2021.

The results of the study are supported by other Anthem national data from IngenioRx, its pharmacy benefits manager. While the overall utilization for medications to treat depression was up in 2020, much of that increase can be attributed to existing users being more adherent to their dosing regimens, according to IngenioRx medication adherence data. New users of these medications increased at the same rate as 2019. The State of the Nation’s Mental Health report results for Virginia showed the following drops in 2020 rates for those treated for mental health diagnoses compared to those treated in 2019:

  • 14 percent overall drop for young children
  • 8 percent overall drop for adolescents
  • 16 percent overall drop for adults older than 75
  • 17 percent drop for young children diagnosed with ADHD
  • 10 percent drop for adolescents diagnosed with ADHD
  • 22 percent drop in adults older than 75 diagnosed with dementia, and a
  • 4 percent drop for both Baby Boomers and adults older than 75 diagnosed for depression.

“While the study did not fully identify the underlying reasons for the change in adherence, we do know that access to routine developmental and well-being screenings, daily attendance at work or school and markedly decreased social interactions resulted in far fewer opportunities to identify the early signs and symptoms of a new or worsening mental health condition,” said Dr. Dempsey. “For children, distance learning meant less face time with teachers, who often recommend testing for mental health or attention related concerns.”

Nearly three out of four mental health specialists and primary care doctors estimated in an Anthem commissioned national survey that mental health repercussions from the virus will last up to three years or longer and almost two-thirds believe their patients’ mental health declined in the second half of the pandemic (Sept. 2020-Feb. 2021) compared to the first half (March-Aug. 2020).

“When people encounter significant stress, we expect the trend for new or emerging mental health conditions to increase,” said Dr. Dempsey. “This highlights the need for much greater awareness and ongoing surveillance of the mental health impact from the pandemic for the foreseeable future. However, this does not mean we should discount the protective effect of positive home environments, bolstered by more frequent parental interaction, family-centered meals and activities and the natural resilience of children.”

On another positive note, nine out of 10 healthcare professionals surveyed said that COVID-19 has made them more aware of the mental health conditions their patients’ experience. Seventy percent of healthcare professionals said their patients have been more willing to proactively bring up mental health concerns during appointments.

A majority of healthcare professionals said that patients who were already seeking therapy or in a support group prior to the start of the pandemic have more successfully coped with their mental health concerns. And, many noted they are seeing an increased emphasis in patient self-care and better work/life flexibility.

“People in general and young people in particular should not be reluctant to seek mental health help when they need it,” said Paul Gionfriddo, president and CEO of Mental Health America, the nation’s largest mental health advocacy organization. “We know from the millions of help-seeking people who have reached out to us this past year that more people than ever are in need of help, and we want them to know that it is a show of strength, not weakness, to seek that help as early as possible, and the first step on the pathway to recovery.”

Information about how to recognize the signs and symptoms of mental health conditions is available at the State of the Nation’s Mental Health report web site and the Mental Health America web site.

Survey and Claims Methodology

The State of the Nation’s Mental Health report is based on claims data from 27 million members in Anthem affiliated individual, employer-sponsored, Medicare and Medicaid health plans in all states, including more than 2 million in Virginia. Prevalence of behavioral health diagnoses each year (2019 and 2020) was determined by the number of individuals with at least one claim containing a behavioral health diagnosis during the calendar year divided by the number of members enrolled in the plans.

The Anthem online survey was conducted among a national sample consisting of 552 healthcare professionals, broken out into 285 behavioral health specialists and 267 primary care physicians/general practitioners living in the United States, with an oversample of 100 rural healthcare professionals. The sample includes a diverse set of respondents across key demographics (age, gender, region, race/ethnicity) and experience as a physician (time spent in practice, type of practice, size of practice). The margin of error for the total sample at the 95 percent confidence level is +/- 4 percentage points.

About Anthem Blue Cross and Blue Shield

Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. are independent licensees of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Virginia is available at Also, follow us on Twitter at and on Facebook at


Scott Golden
Anthem Blue Cross and Blue Shield

Release Summary

Anthem BCBS in VA's State of the Nation's Mental Health report finds there wasn’t a corresponding increase in people seeking mental health treatment.


Scott Golden
Anthem Blue Cross and Blue Shield