Exposures to traumatic events may be associated with poor behavioral health outcomes. Findings from a previous COVID-19 literature review indicate that symptoms of post-traumatic stress disorder (PTSD), acute stress, and anxiety are more likely to be present for months and years in individuals exposed to public health crises. Emerging evidence of increased need for mental health and substance use disorder (SUD) services during the COVID-19 pandemic is consistent with these observations.

This study will estimate the increase in needed mental health and SUD services due to the COVID-19 pandemic by considering trends in service utilization and unmet need immediately after past public health and national emergencies. This project will use behavioral health enrollment and claims data from Medicaid and from a large vendor of health plan data to assess utilization of mental health services for mild-to-moderate behavioral health conditions.

Research for this study will build on the previous year’s literature review aimed to forecast prevalence of behavioral health conditions and workforce needs due to the COVID-19 pandemic. Four additional states will be added for comparison purposes. Results will also be used to generate recommendations for employers seeking to implement behavioral health support mechanisms both for essential staff currently working, including frontline health care staff as well as employees returning to work.



In March 2020, COVID-19 profoundly impacted day-to-day life. Disruption of daily life can lead to decreased mental health in areas such as anxiety, depression, and substance use. To address increasing behavioral health needs, laws were implemented to allocate funding for behavioral health services and expand coverage of virtual health services. This made telehealth more accessible and there was an increased use of telebehavioral health services during the pandemic.

By examining service use before and during the COVID-19 pandemic, a large increase in the overall percentage of mental health procedures and diagnoses was discovered. Similarly, the use of virtual health visits increased, with nearly 50% or more of all mental health appointments conducted via telehealth during the pandemic. As the COVID-19 pandemic continues, it is essential to understand its influence on mental health needs in order to better address workforce capacity.