GAO report finds increased behavioral health symptoms and decreased access

The U.S Government Accountability Office (GAO) recently released a report detailing how behavioral health conditions increased while accessibility to behavioral health treatment decreased during the pandemic. The report used numbers from multiple states, including Oregon.


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According to the report, the Centers for Disease Control (CDC) Household Pulse conducted a survey from April 2020 to February 2021 which found that 38% of adults, across 24 survey collection periods, reported symptoms of anxiety or depression. In 2019, only 11% of respondents reported these symptoms. 

The report also found an increase in overdose deaths and suicide attempts. CDC analysis found that emergency room visits for overdoses and suicide attempts were 36% and 26% higher, respectively. 

This increase in behavioral health symptoms is challenged by limited behavioral health services. 

According to the report, the Health Resources and Services Administration (HRSA) designated 5,700 mental health provider shortage areas, with one-third of Americans living within these areas as of September 2020. Stakeholders from hospital associations in Oregon noted the lack of a community-based behavioral health workforce, which leads to longer in-patient stays. 

This is not a new problem. In 2013, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that 3.9 million adults had a serious mental illness who had unmet needs for care within the last 12 months. 

During the pandemic, behavioral health treatment services were hit hard due to staff layoffs and loss of providers without financial resources to continue to operate. Providers interviewed by GAO pointed to a lack of available resources to provide care in person and limited capacity for inpatient services as significant stressors on their effectiveness and profitability.

According to the report, hospital system representatives in Oregon highlighted that certain inpatient behavioral health claims from Medicaid members were often denied. 

The report was addressed to U.S. Sen. Ron Wyden, chair of the Committee on Finance in the U.S. Senate.