A CLOSER LOOK AT BEHAVIORAL HEALTH And the impact of COVID-19

The increasing prevalence of behavioral health conditions continues to be a top concern for employers. Meeting the needs of your employees facing mental health challenges takes looking at the bigger picture, in order to better treat the whole person. The critical first step is understanding the full scope of behavioral health conditions, their impact on your workforce and how the COVID-19 pandemic is already factoring in. 1 IN 5 adults experience a diagnosable mental health condition in any given year, more than half will go untreated1 200M+ workdays missed due to mental health conditions each year2 $16.8B lost in productivity due to mental health conditions each year2 1 Center for Workplace Mental Health, American Psychiatric Association Foundation, “Investing In A Mentally Healthy Workforce Is Good For Business,” 2020. 2 Kelly Greenwood, Vivek Bapat, Mike Maughan, “Research: People Want Their Employers to Talk About Mental Health,” Harvard Business Review, 2019. A growing concern. Before you can address the impact of any health condition on your workforce, you need a better understanding of the numbers behind it. For behavioral health, the stats are staggering. Top 10 Behavioral Health Conditions3 Rank 2014 2018 Increase in prevalence (from 2014-2018) 1 Anxiety 11.2 15.5 39% 2 Tobacco Use Disorder 5.4 8.3 53% 3 Major Depressive Disorder 3.8 6.2 62% 4 Hyperactivity 4.1 5.0 22% 5 Substance Use Disorder 1.3 1.9 51% 6 Alcohol Use Disorder 1.4 1.8 25% 7 Bipolar Disorder 0.7 1.1 52% 8 Cognitive Impairment 0.6 1.0 51% 9 Psychotic Disorders 1.1 0.8 -26% 10 Intellectual Disabilities 0.1 0.1 — Prevalence for Overall (Rate per 100) 3 Ages 18-64, Blue Cross Blue Shield Health Index. “Behavioral health issues are going to impact not only the quality of life, but it’s also going to have a significant impact on employee effectiveness, their working relationship, and their productivity on the job.” VP, HUMAN RESOURCES, RETAIL An all ages issue. While the conditions affecting each generation the most can vary, the bottom line is that the impact of behavioral health is growing across all age groups. Behavioral Health Conditions4 Increase in Prevalence (2014-2018) Anxiety Tobacco Use Disorder Major Depressive Disorder Hyperactivity Substance Use Disorder 34% Gen Z Born Between 1997-2002 (Age 18–23) 21.8% Millennials Born Between 1981-1996 12.1% Gen X Born Between 1965-1980 13.8% Boomers Born Between 1946-1964 Gen Z Born Between 1997-2002 (Age 18–23) Millennials Born Between 1981-1996 Gen X Born Between 1965-1980 Boomers Born Between 1946-1964 Gen Z Born Between 1997-2002 (Age 18–23) Millennials Born Between 1981-1996 Gen X Born Between 1965-1980 Boomers Born Between 1946-1964 Gen Z Born Between 1997-2002 (Age 18–23) Millennials Born Between 1981-1996 Gen X Born Between 1965-1980 Boomers Born Between 1946-1964 Gen Z Born Between 1997-2002 (Age 18–23) Millennials Born Between 1981-1996 Gen X Born Between 1965-1980 Boomers Born Between 1946-1964 4 Blue Cross Blue Shield Health Index. Millennials and mental health. By 2030, Millennials will make up 75% of the workforce, so it’s critical that we continue to recognize and address the mental health challenges of this generation.5 LEARN MORE 6 OF THE 10 top health conditions affecting Millennials are behavioral health conditions5 ONLY 49% of Millennials think of their mental health as “very good” or “excellent”6 5 Blue Cross Blue Shield, The Health of America Report®, The Health of Millennials. April 2019. 6 Blue Cross Blue Shield Association, National Generation Survey. 2019. A challenging time. As we continue adjusting to the new normal of COVID-19, it’s important to keep an eye on the effect this pandemic is having on behavioral health. With so many of us worried about not just the disease itself, but its effect on our ability to keep working, we’re seeing data that shows certain behaviors are on the rise since the outbreak began—especially among the younger generations. 27% are “very” or “extremely worried” about the coronavirus Millennials (37%) Boomers (22%)7 9% report losing their job since the start of the pandemic Gen Z (14%) Millennials (13%) Gen X (14%) Boomers (6%)7 51% report having a CDC-identified underlying condition that puts them at greater risk Gen Z (39%) Millennials (13%)7 7 Blue Cross Blue Shield Association. COVID-19 National Pulse Survey. 2020. Behavioral Change Since the Pandemic Began The pandemic is affecting us all, with 93% reporting at least one behavior change since the outbreak began.7 Positive behaviors Negative behaviors Total Gen Z Millennials Gen X Boomers % Adults 18+ 32% Exercising more 51% 42% 31% 21% 45% Taking outdoor walks more often 58% 46% 46% 40% 57% Talking on the phone or video chat more with friends and/or family 75% 64% 56% 49% 59% Spending more time with family 73% 65% 60% 50% Total Gen Z Millennials Gen X Boomers % Adults 18+ 47% Eating more food 59% 54% 47% 38% 21% Drinking more alcohol 25% 32% 21% 11% 12% Smoking more 16% 19% 11% 6% 8% Vaping more 17% 13% 6% 2% 7% Using drugs for non-medical purposes 19% 12% 4% 2% Behind the numbers These behaviors may lead to further increases in conditions like anxiety, major depressive disorder as well as tobacco, substance and alcohol use disorder. The good news: Virtual care has increased 1.6X since summer 2019, and half that growth came since the start of the COVID-19 pandemic.8 23% used telehealth since the pandemic started Millennials (30%) used telemedicine 2X more than Boomers (15%)7 8% started speaking with a therapist, counselor or mental health professional Gen Z (17%) Millennials (13%)7 75% of people with behavioral health conditions are continuing therapy services during COVID-197 8 BCBSA National Generation Survey. 2019; BCBSA COVID-19 National Pulse Survey. 2020.