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Behavioral health equity: scale of impact

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BEHAVIORAL HEALTH EQUITY scale of impact

Behavioral health conditions are on the rise, 1 and stark disparities exist that are disproportionately affecting marginalized groups — especially people of color. The first step in providing support for your workforce is grasping the extent of behavioral health disparities. $16T Mental health conditions are pr ojected to contribute to $16 trillion in lost productivity by 2030 . 2 ↑ 3X Estimates show that those of the lowest socioeconomic status are up to 3X more likely to have a mental health condition. 3 63% 63% of Black adults believe that a mental health condition is a sign of personal weakness, which could lead those with a mental health challenge to worry about discrimination. 4 Take a closer look at the staggering scope of behavioral health disparities across racial, socioeconomic and geographic groups. RECEIVING CARE ONLY 1 IN 3 Only 1 in 3 Black adults who need mental healthcare receive it. 5 - Only about 34% of Hispanic/Latino adults with mental health conditions receive treatment each year, compared to the U.S. average of 45%. 6 STARTING AND STAYING IN TREATMENT 20% - 50% LESS LIKELY Due to stigma, people of color are 20% – 50% less likely to seek out mental healthcare, and 40% – 80% more likely to end treatment prematurely. 7 - Rates of prescription treatment for diagnosed major depression are 33% lower for Hispanic communities and 13% lower for Black communities than for white communities . Rates of counseling for diagnosed major depression are also 21% lower for Hispanic communities than white communities. 8 UNDERDIAGNOSIS 30 - 40% LOWER Dropdown copy: - Likely due to underdiagnosis, majority Black and Hispanic communities have a 30 - 40% lower diagnosis rate of major depression than white communities. 9 - Early and consistent screening combined with the context of known risk factors has been found to help detect and treat postpartum depression. 10 But according to a recent survey from Blue Cross Blue Shield Association, 34% of Black women and 38% of Hispanic women said they were not screened for postpartum depression or did not know if they were screened. 1 1 Learn more about maternal health disparities in Volume #2 of our Health Equity mini - eMagazine series . GEOGRAPHIC IMPACT 80% LACKING 80% of all rural counties are lacking even a single psychiatrist. 1 2 This is especially relevant given the change in moving patterns over the last two years — six of the top ten states with the highest inbound moving percentages of 2021 are among the 20 least densely populated states in America. 1 3 SOCIOECONOMIC STATUS 35% EARNING <$40K Socioeconomic status also reflects sizable disparities that have been amplified by COVID - 19. 35% of adults with less than $40K a year in household income reported a major negative impact to their mental health due to the pandemic, versus 21% with $40K - $89K and 17% with $90K or more. 1 4 - Adults who are uninsured or low - income are more likely to experience serious mental health conditions than individuals with insurance or higher incomes. 1 5 CHRONIC CONDITIONS AND COMORBIDITIES 2X AS LIKELY Those diagnosed with a chronic illness are twice as likely to have a behavioral health condition, and those with a behavioral health condition are more likely to have a chronic illness. 1 6 Comorbidities such as this are associated with worse health outcomes, more complex clinical management and increased healthcare costs. 1 7 - People of color are up to two times more likely to have major long - term conditions when compared to white people. 1 8 Impact on employers Body copy: With people of color projected to make up over half of the U.S. population by 2050, 1 9 persistence of behavioral health disparities among diverse segments of the workforce could have significant impacts on businesses. Depression is one condition in particular that has massive cost implications both to the well - being of the workforce and to organizations. Addressing behavioral health equity is good business. More than 80% of employees treated for mental health conditions report improved levels of work efficacy and satisfaction. And it's cost-effective. When employees receive equitable, effective treatment for mental health, the result is lower total medical costs, increased productivity, lower absenteeism and decreased disability costs. 20 LOST PRODUCTIVITY $1T The flu costs $1,000 in lost productivity per employee per year and $10.4B in direct medical costs, while depression costs $9,450 in lost productivity per employee per year and $110B in direct medical costs. 21 Employees with depression also miss between 6 and 25 more days per year and suffer from impaired work performance between 13% and 29% of the time. 22 The estimated cost of depression and anxiety to the global economy is $1 trillion per year in lost productivity. 23 HIGHER MONTHLY COST $560 The healthcare costs for treating individuals with chronic medical and behavioral health conditions are 2 - 3X higher than for those without behavioral health conditions. 24 In dollar terms, patients with untreated depression and a chronic illness hav e monthly healthcare costs that average $560 higher than those with just a chronic disease. Higher levels of comorbidity among people of color make this even more urgent. 25 Advancing behavioral health equity takes all of us. Body copy: There’s much more to learn about the different groups affected by behavioral health disparities, key contributing factors and strategies for employers to change the tide for their workforce. Download our latest Health Equity mini-eMagazine and join the journey to make healthcare more equitable at smarterbetterhealthcare.com

Behavioral health equity: scale of impact

Behavioral health conditions are on the rise,1 and stark disparities exist that are disproportionately affecting marginalized groups—especially people of color. The first step in providing support for your workforce is grasping the extent of behavioral health disparities.

  • $16T

    Mental health conditions are projected to contribute to $16 trillion in lost productivity by 2030.2

  • 3X

    Estimates show that those of the lowest socioeconomic status are up to 3X more likely to have a mental health condition.3

  • 63%

    63% of Black adults believe that a mental health condition is a sign of personal weakness, which could lead those with a mental health challenge to worry about discrimination.4

Take a closer look at the staggering scope of behavioral health disparities across racial, socioeconomic and geographic groups.
Receiving care
only
1in3
  • Only 1 in 3 Black adults who need mental healthcare receive it.5
  • Only about 34% of Hispanic/Latino adults with mental health conditions receive treatment each year, compared to the U.S. average of 45%.6
Starting and
staying in treatment
20-50%
less likely
  • Due to stigma, people of color are 20%-50% less likely to seek out mental healthcare, and 40%-80% more likely to end treatment prematurely.7
  • Rates of prescription treatment for diagnosed major depression are 33% lower for Hispanic communities and 13% lower for Black communities than for white communities. Rates of counseling for diagnosed major depression are also 21% lower for Hispanic communities than white communities.8
Underdiagnosis
30-40%
lower
  • Likely due to underdiagnosis, majority Black and Hispanic communities have a 30%-40% lower diagnosis rate of major depression than white communities.9
  • Early and consistent screening combined with the context of known risk factors has been found to help detect and treat postpartum depression.10 But according to a recent survey from Blue Cross Blue Shield Association, 34% of Black women and 38% of Hispanic women said they were not screened for postpartum depression or did not know if they were screened.11 Learn more about maternal health disparities in Volume #2 of our Health Equity mini-eMagazine series.
Geographic Impact
80%
lacking
  • 80% of all rural counties are lacking even a single psychiatrist.12 This is especially relevant given the change in moving patterns over the last two years—six of the top ten states with the highest inbound moving percentages of 2021 are among the 20 least densely populated states in America.13
Socioeconomic status
35%
earning <$40K
  • Socioeconomic status also reflects sizable disparities that have been amplified by COVID-19. 35% of adults with less than $40K a year in household income reported a major negative impact to their mental health due to the pandemic, versus 21% with $40K-$89K and 17% with $90K or more.14
  • Adults who are uninsured or low-income are more likely to experience serious mental health conditions than individuals with insurance or higher incomes.15
Chronic conditions
and comorbidities
2X
as likely
  • Those diagnosed with a chronic illness are twice as likely to have a behavioral health condition, and those with a behavioral health condition are more likely to have a chronic illness.16 Comorbidities such as this are associated with worse health outcomes, more complex clinical management and increased healthcare costs.17
  • People of color are up to two times more likely to have major long-term conditions when compared to white people.18

Impact on employers

With people of color projected to make up over half of the U.S. population by 2050,19 persistence of behavioral health disparities among diverse segments of the workforce could have significant impacts on businesses. Depression is one condition in particular that has massive cost implications both to the well-being of the workforce and to organizations.

Addressing behavioral health is good business.

Learn More
More than 80% of employees treated for mental health conditions report improved levels of work efficacy and satisfaction. And it's cost-effective. When employees receive equitable, effective treatment for mental health, the result is lower total medical costs, increased productivity, lower absenteeism and decreased disability costs.20
Lost productivity
$1T
The flu costs $1,000 in lost productivity per employee per year and $10.4B in direct medical costs, while depression costs $9,450 in lost productivity per employee per year and $110B in direct medical costs.21 Employees with depression also miss between 6 and 25 more days per year and suffer from impaired work performance between 13% and 29% of the time.22 The estimated cost of depression and anxiety to the global economy is $1 trillion per year in lost productivity.23
Higher
monthly cost
$560
The healthcare costs for treating individuals with chronic medical and behavioral health conditions are 2-3X higher than for those without behavioral health conditions.24 In dollar terms, patients with untreated depression and a chronic illness have monthly healthcare costs that average $560 higher than those with just a chronic disease. Higher levels of comorbidity among people of color make this even more urgent.25

Advancing behavioral health equity takes all of us.

There’s much more to learn about the different groups affected by behavioral health disparities, key contributing factors and strategies for employers to change the tide for their workforce. Download our latest Health Equity mini-eMagazine and join the journey to make healthcare more equitable at smarterbetterhealthcare.com.

Learn More
eMagazine cover for Behavioral Health Equity Crisis on iPad Mini

1 Ages 18-64, Blue Cross Blue Shield Health Index, 2018.

2 Kelly McCain and Philip Campbell, “Declines in Mental Health Workforce Need to Be Met by More Rigorous Employer Support,” Scientific American, Sept. 14, 2021.

3 Young-Mee Kim, PhD, and Sung il-Cho, PhD, MD, “Socioeconomic Status, Work-Life Conflict, and Mental Health,” American Journal of Industrial Medicine, May 17, 2020.

4, 5 “Identity and Cultural Dimensions: Black/African American,” Your Journey, National Alliance on Mental Illness (NAMI).

6 National Alliance on Mental Illness (NAMI), “Hispanic/Latinx,“ 2021.

7 Neil Krishan Aggarwal, et al., “Clinician Descriptions of Communication Strategies to Improve Treatment Engagement by Racial/Minorities in Mental Health Services: A Systematic Review,” Patient Education and Counseling, Feb. 2016, 198–209, cited in National Center for Biotechnology Information/US National Library of Medicine, National Institutes of Health.

8, 9 Blue Cross Blue Shield Association, Analysis on Racial Disparities in Diagnosis & Treatment of Major Depression, 2022.

10 Zoleykha Asgarlou, Mohammad Arzanlou, and Mohammad Mohseni, “The Importance of Screening in Prevention of Postpartum Depression,” Iranian Journal of Public Health, May 2021, 1072–1073, cited in National Center for Biotechnology Information/US National Library of Medicine, National Institutes of Health.

11 Blue Cross Blue Shield Association, Maternal Health Survey. 2020.

12 New American Economy, “New Study Shows 60 Percent of U.S. Counties Without a Single Psychiatrist, One-Third of All Psychiatrists Nationwide Trained Abroad,” Oct. 23, 2017.

13 Annual 2021 United Van Lines National Movers Study, United Van Lines, Jan. 3, 2022.

14 Nirmita Panchal, Rabah Kamal, and Cynthia Cox, “The Implications of COVID-19 for Mental Health and Substance Use,” KFF (Kaiser Family Foundation), Feb. 10, 2021.

15 The Costs and Consequences of Disparities in Behavioral Health Care, National Conference of State Legislatures, Feb. 2018.

16, 25 Steven Ross Johnson and Harris Meyer, “Behavioral Health: Fixing a System in Crisis,” Modern Healthcare, Jun. 12, 2017.

17 Jose M. Valderas, MD, et al., “Defining Comorbidity: Implications for Understanding Health and Health Services,” Annals of Family Medicine, July 2009, 7(4): 357–363.

18 Rachel Reiff Ellis, “Minorities and Chronic Disease: Obstacles to Care,” WebMD, Oct. 7, 2020.

19 Nambi Ndugga and Samantha Artiga, “Disparities in Health and Health Care: 5 Key Questions and Answers,” KFF (Kaiser Family Foundation), May 11, 2021.

20 Center for Workplace Mental Health, American Psychiatric Association Foundation, “Investing in a Mentally Healthy Workforce Is Good for Business,” 2020.

21 Don Mordecai, MD, ”Mental Health at Work - Why Stigma Is a Workforce Health Issue,” Kaiser Permanente Business, March 18, 2019.

22 “The High Cost of Mental Disorders: Facts for Employers,” One Mind At Work.

23 Mental Health in the Workplace, World Health Organization.

24 Milliman Research Report, “Potential Economic Impact of Integrated Medical-Behavioral Healthcare, Implications for Psychiatry,” 2014.

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