America's State of Mind Report

Our latest research report examines use of medications to treat three of the most common mental health conditions: depression, anxiety and insomnia; provides early insights into the impact of the COVID-19 pandemic on America’s mental health.
America's State of Mind Report

While COVID-19 makes its monumental mark on the world’s health and economy, new research from Express Scripts reveals it is also making a significant impact on many people’s mental health. 

Our research shows that the number of prescriptions filled per week for antidepressant, anti-anxiety and anti-insomnia medications increased 21% between February 16 and March 15, peaking the week ending March 15, when COVID-19 was declared a pandemic.

It’s understandable. Americans have grown increasingly anxious as they’ve seen this global pandemic upend their lives within a very short time. This analysis, showing that many Americans are turning to medications for relief, demonstrates the serious impact COVID-19 may be having on our nation’s mental health.

The greatest increase was in prescriptions for anti-anxiety medications, which rose 34.1% from mid-February to mid-March, including a week-over-week spike of nearly 18% during the week ending March 15. The number of prescriptions filled for antidepressants and sleep disorders increased 18.6% and 14.8%, respectively, from February 16 to March 15.

We also observed that:

  • More than three quarters (78%) of all antidepressant, antianxiety and anti-insomnia prescriptions filled during the week ending  March 15th (the peak week) were for new prescriptions.
  • The percent increase in the number of new prescriptions  between the week of February 16 and week ending March 15 for the all three categories was 25.4%
  • The percent increase in the number of new prescriptions between the week of February 16 and week ending March 15 for anti-anxiety medications was 37.7%


In-depth Analysis of Depression, Anxiety and Insomnia Medications

The rise in anti-anxiety medications is particularly striking given data from a new Express Scripts research report, America’s State of Mind, which found that until now, the use of these drugs had been declining over the past five years. The report, which examines mental health medication trends from 2015 through 2019 among 21 million people with employer-funded insurance, documents a decline in the use of anti-anxiety medications of more than 12% and a similar decline in the use of anti-insomnia medications, down 11.3%.

While the recent increased use of medications to treat anxiety, depression and sleep disorders is sudden, it is encouraging to see our members recognizing the need for help and seeking support from their physician. What’s crucial now is ensuring Americans who are experiencing symptoms of these mental health conditions have support and access to their physicians, therapists and educational resources, including digital tools and virtual care and counseling to help them cope during this time.


Use of Antidepressants by Adolescents Escalated in the Past Five Years

While use of medications for anxiety and insomnia have declined over the past few years, America’s State of Mind report documents that the use of antidepressants, especially among American teenagers, has increased significantly.

Overall, there was a 15% jump in the number of people taking antidepressants from 2015 through 2019; and among teens (13-19 years old), the use of these medications rose 38%, highlighting an alarming need for mental health care services in this age group. This dramatic increase in antidepressant use was seen among both boys and girls, but the ratio use remained relatively constant with twice as many girls (10.2%) than boys (5.7%) in that age group taking an antidepressant in 2019.

While there’s evidence that more teenagers and young adults are suffering with mental health conditions than past generations, they also are getting access to help and receiving needed treatment.


Express Scripts Solutions

Express Scripts is taking on the growing mental health challenge by improving the care we provide to members living with mental health conditions.

  • Express Scripts is supporting members through the COVID-19 pandemic by working with SilverCloud Health to make their digital mental health platform available to clients and their members at no cost. 

  • Through our Neuroscience Therapeutic Resource Center®, we provide health coaches, pharmacists, nurses and social workers who specialize in caring for members with complicated and costly mental health conditions, including depression, anxiety and insomnia.
  • Using RationalMed®, our award-winning medication safety program, we warn prescribers and pharmacists, when appropriate, about the patient’s potential use of more than 200 medications that may cause or exacerbate depression or the risk of suicide.
  • The Express Scripts Digital Health Formulary®, which makes access to digital health solutions easy and affordable for patients and plans who need them, includes solutions for patients with anxiety, depression, insomnia and other mental health conditions.

Education and access to care are critical to supporting patients with a mental health condition. Express Scripts will continue to bring services and solutions to clients and their members.

Download Report
Discover more data and insights now with easy access to the Express Scripts America's State of Mind Report.