Behavioral Health Visit Volumes Soar as Primary Care Dips

Behavioral health care visit volumes have increased by more than 20% since the pandemic. Meanwhile, primary care volumes have dipped.

This is primarily driven by an increase in visit volumes for anxiety, eating disorders and substance use disorder care, according to the 2023 Trends Shaping the Health Economy report by Trilliant Health. Visit volumes for anxiety disorders increased by 44.9% from 2019 to 2022. While visits for behavioral health conditions are on the rise overall, there has been a slight dip in visits for schizophrenia and ADHD.

Behavioral health visit volumes have only continued to rise since the pandemic. Between 2021 and 2022, behavioral health visits increased by 2.8%. Meanwhile, the volume of all other health care visits fell by 0.4%.


“In our research, we have observed a growing disease burden of behavioral health conditions across age segments for years – a trend that was further accelerated by the pandemic,” Sanjula Jain, chief research officer at Trilliant Health, told Behavioral Health Business in an email. “What stands out, however more recently, is the disproportionate increase in behavioral health conditions, notably eating disorders, anxiety and depression, among youth. This is likely a result of many factors such as rise in social media use among and pandemic-related changes in social interaction from learning in-person to virtually.”

Photo credit: Trilliant Health

Behavioral health conditions have disproportionately impacted young people. Visits addressing eating disorders among youth have increased by more than 90%, and nearly 40% for depression.

Jain noted that while she isn’t an operator or clinician, she does foresee an effective solution to solving the youth behavioral health crisis involving a more nuanced and data-driven understanding of the situation to understand the underlying factors better.


“For example, insight into ZIP code level quantification of current behavioral health provider supply relative to current, and more importantly, projected demand for services could better inform strategies designed to address the supply challenges,” Jain said.

But, the industry may not be ready to meet the behavioral health needs of patients in the future. By 2035, the projected adequacy for adult psychiatry is 69.3% of the total demand.

Still, some behavioral health specialties are rapidly growing. For example, by 2035, psychiatric nurse practitioners will be at a 212.4% adequacy level.

“Despite this growing need, the number of behavioral health providers does not meet current or projected demand,” Jain said. “At a national level, adequacy of allied behavioral health providers is projected to be sufficient, but MD/DO psychiatry supply is not currently meeting demand and is projected to stay below 100% for adult psychiatry. It is also important to remember that that demand for services is primarily a function of care trends and population shifts, which are market specific.”

Photo credit: Trilliant Health

Telehealth has often been pitched to help increase the supply of services. And behavioral health visits continue to make up the majority of telehealth visits in the country.

Behavioral health accounted for 62.8% of telehealth visits in Q4 2022.

“The fact that the majority of telehealth volumes have consistently been attributed to behavioral health further reinforces the fact that when given a choice between virtual or in-person care, consumers are largely choosing in-person care with the exception of behavioral health, which is another measure of ‘replacement,’” Jain said.

Although many consumers are turning to telehealth to address behavioral health concerns, 56.5% are following up with an in-person follow-up visit within three weeks.

Photo credit: Trilliant Health

Some of the most common diagnoses requiring a follow-up behavioral health visit are stress, anxiety disorders, major depressive disorders, and bipolar disorder, among others.

“There are likely two pathways for follow-ups related to tele-behavioral health. First, severe cases may necessitate that the patient be seen in-person for more intensive treatment or evaluation,” Jain said. “Second, omni-channel utilization, where a patient sometimes sees their provider via telehealth and sometimes goes in person, for a variety of reasons ranging from convenience to wanting to build a stronger relationship with the provider and/or perceived quality of care associated with the provider relationship.”

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