Anthem Blue Cross and Blue Shield Data Reveals Disconnect Between Increased Stress and Lower Diagnoses Rates

Pandemic leads to decrease in mental healthcare over 2020 calendar year, says State of the Nation’s Mental Health report

INDIANAPOLIS--()--While people in the U.S. have reported 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.

In Indiana, data shows significantly fewer mental health diagnoses last year, particularly among children and adolescents, compared to 2019.

These findings, part of a new State of the Nation’s Mental Health report based on Anthem Blue Cross and Blue Shield claims from 1.8 million Hoosiers, 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 data indicates that many people who may benefit from mental health services, especially children, either aren’t being identified or aren’t reaching out to get the help they might need,” said Keith Knuth, M.D., medical director for Anthem Blue Cross and Blue Shield in Indiana. “Just as we get vaccinated to protect ourselves from COVID-19, we must recognize the importance of helping individuals find the resources they need to improve their mental health, which may have suffered during the pandemic. This is part of Anthem’s focus on the whole health of the individual.”

The results of the study are supported by other national data from IngenioRx, Anthem’s 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 in Indiana showed the following drops in treatment for mental health diagnoses in 2020 compared to 2019:

  • 10 percent overall drop for young children
  • 5 percent overall drop for adolescents
  • 13 percent drop for young children diagnosed with ADHD
  • 9 percent drop for adolescents diagnosed with ADHD

“We can’t say for certain why there were fewer mental health diagnoses for young people last year, but we speculate that they weren’t interacting as often with people in the community, such as teachers, primary care physicians and family relatives who are often the first to spot potential issues,” said Knuth.

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 (September 2020-February 2021) compared to the first half (March-August 2020).

On a 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 are experiencing. 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, including 1.8 million in Indiana. 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 Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., an independent licensee of the Blue Cross and 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 Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Indiana is available at Also, follow us on Twitter @AnthemBCBS_News and @AnthemBCBS or find us on Facebook.


Tony Felts,

Release Summary

Despite the pandemic, data from Anthem Blue Cross and Blue Shield shows fewer mental health diagnoses in Indiana in 2020 compared to previous year.


Tony Felts,