Webinar Recap: The Invisible Effects of Mental Health Disorders

Our recent webinar explored our latest research endeavor, America’s State of Mind, and shared new perspectives on mental health in the workplace. Rochelle Henderson, vice president of research, shares her thoughts.

My colleagues and I have been talking a lot about mental health lately, and we’re committed to sharing what we’ve learned.

Recently, we published America’s State of Mind, which examines the use of medications to treat three of the most common mental health conditions: depression, anxiety and insomnia.  We also studied emerging trends in the use of these medications as a result of the COVID-19 pandemic.

This research comes at a critical time as our clients tell us the impact and costs related to mental health is taking a toll on the well-being of their employees and their business. That’s understandable as we take into account these factors:

  • Mental health is one of the costliest medical conditions in the U.S.
  • Approximately 24 percent of all costs caused by workplace accidents and errors are associated with insomnia
  • Americans miss 16 million work days per year due to mental health conditions
  • Health care costs are 2-3 times higher for patients with both a mental health condition and chronic disease

While once considered a “personal health issue,” a mental health condition can and should be viewed with the same lens we view any other physical health condition, with a focus on education and treatment.

In this webinar, I had the opportunity to discuss findings from America’s State of Mind report, with psychiatrist and addiction medicine physician, Dr. David Muzina, MD, Senior Medical Director of Clinical Operations, Medical Mutual.

These are three takeaways from our discussion:

1. Data Drives Insights

At Express Scripts, our role in a patient’s care allows us the ability to use actual, de-identified pharmacy and medical claims for tens of millions of people to track unique trends in the use of medications, and put those observations to use by identifying opportunities to better support patients and improve their care.

For example, our research shows that:

  • As COVID-19 began to significantly impact the U.S., the number of prescriptions filled per week for antidepressant, anti-anxiety and anti-insomnia medications increased 21 percent between February 16 and March 15, 2020. Over the same period, prescriptions for anti-anxiety medications rose 34 percent.
  • The use of antidepressants increased by 15 percent from 2015 to 2019, with women’s use of antidepressants more than twice that of men’s. Women 45-64 years old had the highest prevalence of antidepressant use.
  • Teens (ages 13-19) experienced the greatest increase in antidepressant use from 2015 through 2019, up a significant 38.3 percent, and the prevalence of use was higher for teenage girls than boys the same age.

Through America’s State of Mind research, we better understand the burden of disease for those with mental health disorders and potential areas of unmet need.

2. The Mind and Body Connection is Clear

Just as physical health conditions can degrade our mental health, mental health conditions can worsen our physical health. Across the various chronic conditions, patients with one of the conditions shown below are also taking an antidepressant medication. Patients with depression have a 40 percent higher risk of developing cardiovascular and metabolic diseases than the general population.

The image below shows the prevalence of physical and mental health comorbidities.


3. Let’s Focus on Whole Person Health

Every patient has a unique mental health journey, which may include appropriate use of medication, but should also include education and other resources and actions. Here are just a few:

  • Digital behavioral health tools are quickly expanding access to treatment and providing complementary care. These online programs and apps are particularly well-suited for cognitive behavioral therapy approaches, which have become one of the first-line treatments for a variety of mental health conditions. Evidence shows that these programs can be extremely effective in the treatment of anxiety, depression and insomnia, as well as suicide prevention. Express Scripts is now partnering with SilverCloud Health to help members build resilience and develop skills to better manage stress and sleep issues.
  • Tried and true healthy approaches to exercise, nutrition and sleep hygiene
  • Talk therapy with a counselor
  • Community support

The rising prevalence of mental health conditions is a national health challenge and requires customized, accessible care beginning at the local level. The research provided in America’s State of Mind offers new insights to help us partner with providers and payers to better recognize, treat and care for people with mental health needs.

To read all the insights available in America’s State of Mind report, click here.