The U.S. is experiencing a national mental health crisis that emerged well before COVID-19. According to the National Institutes of Health, one in five American adults, or roughly 52 million people, struggles with mental illness– and less than half receive treatment.  The statistics are consistent in Georgia with more than 2 million of the state’s 10.7 million residents living with mental illness.
COVID has only exacerbated the situation with social isolation, new parental challenges, job loss and other economic effects. And the fear of contracting the virus all contribute to heightened levels of stress and anxiety. According to a 2021 study from the Kaiser Family Foundation, approximately four in 10 adults nationwide reported symptoms of anxiety or depressive disorder during the pandemic— a four-fold increase from pre-pandemic levels.
The 2020 Drug Trend Report from Evernorth, the parent organization of pharmacy benefits management company Express Scripts, offers additional evidence of the effects of the pandemic on Americans’ mental health. The analysis shows that, while use of other mental health medications stabilized after a spike in use at the start of the COVID-19 pandemic, overall use of antidepressant medications increased 7.9 percent between 2019 and 2020.  
As we look to return to normalcy, with employees coming back to the workplace in some capacity, the American Psychological Association reported the highest levels of stress in the U.S. since April 2020. Half of adults reported being uneasy about returning to in-person interactions.
The High Cost of Poor Mental Health
It’s no surprise that poor mental health has costs for health plans and employers. Research shows that employers see double digit losses in productivity for employees with symptoms of major depression.
Research also shows that taking steps to improve mental health can reduce net cost of care, especially among individuals suffering from multiple chronic illnesses or complex conditions. Some studies indicate it can generate cost savings as high as 20 percent.
The value of improving access to mental health services has not been lost on Georgia lawmakers. In March 2021, the General Assembly passed the FY 2022 budget that earmarks nearly $59 million to fund mental health services for some of state’s most vulnerable populations.

Addressing Issues Contributing to the Problem

Many adults struggling with mental health conditions are simply unable to get help due to the severe shortage of mental health professionals. 6 A report from the Georgia Behavioral Health Reform and Innovation Committee found that all but nine of Georgia’s 159 counties have shortages in parts of their mental health workforces.
Telehealth is helping to close some of the gaps, and Americans are embracing it. In a recent consumer study from MDLIVE, an Evernorth company that provides psychiatric care and therapy via telehealth, 55 percent of respondents said they were open to using telehealth for behavioral health services.

Georgia legislators clearly see the value of telehealth for improving access to care. The state has invested over $250 million its behavioral health system since 2011 as part efforts to meet the terms of a legal settlement with the U.S. Department of Justice. This year the Georgia General Assembly unanimously passed legislation aimed at increasing the delivery of care via telehealth that prohibits, among other things, separate insurance deductibles for telehealth care.

Evernorth and Express Scripts have responded to the call for comprehensive behavioral health offerings – from network, access, and utilization management to intensive coaching – to treat conditions ranging from depression and anxiety to substance abuse, autism, and eating disorders. With pharmacy often being the entry point of treatment for individuals who need behavioral health support, Express Scripts serves as the anchor for coordinating care.
Additionally, as the health care system in America becomes more complicated, it becomes more fragmented and costly. Evernorth’s inMynd solution helps health plans and their members better recognize and treat mental health conditions using the industry’s first predictive models for the progression of anxiety, depression, and insomnia to proactively meet each member on their personal journey.
A holistic strategy is vital to improving patient outcomes and reducing health care costs. Express Scripts and the other Evernorth companies remain committed to working with our payor and provider partners to expand and evolve our services and solutions to meet the challenges of the pandemic in Georgia, and beyond.
Dr. Zelis is a board-certified family physician with more than 20 years of clinical experience. She currently serves as Chief Medical Officer for MDLIVE, an Evernorth company and leading national provider of virtual care services. 



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