Assessing Adolescent Mental Health Prevalence and Incidence Pre- and Post-COVID-19 Among Texas Medicaid Recipients
Author(s)
Yihua J. Lee, MPH, Jamie C. Barner, PhD;
Division of Health Outcomes, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
Division of Health Outcomes, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
Presentation Documents
OBJECTIVES: Assess the impact of the COVID-19 pandemic on mental health (MH) diagnoses incidence and prevalence among Texas Medicaid adolescents.
METHODS: This Texas Medicaid retrospective cohort study included adolescents 10-19 years from 2017 to 2023. Pre-existing MH diagnoses were excluded for incidence. Both incidence rate and period prevalence were calculated based on each individual year. Diagnoses (ICD-10 codes) included mood, behavioral, suicide-related, substance use, and psychosis. Descriptive and inferential statistics were employed.
RESULTS: Overall prevalence (Ns range: 1,550,281 to 1,874,542) increased from 2017-1019 (17.5% to 19.3%) and decreased from 2020-2023 (18.4% to 17.3%). Mood and behavioral diagnoses prevalence increased from 2017-2019 (6.7% to 8.2% and 9.1% to 9.2% respectively). Mood diagnoses plateaued in 2020 and then started to increase, while behavioral diagnoses declined after 2020. Suicide-related (0.5% to 0.7%) and substance use (0.8% to 0.9%) diagnoses increased steadily from 2017 to 2023, but substance use diagnosis declined in 2020 (0.7%) during the early COVID-19 waves. Overall incidence (Ns range: 806,425 to 1,054,537) decreased from 2017-1019 (17.7% to 16.5%) and continued from 2020-2023 (11.1% to 11.2%). Incidence of all diagnoses declined during the early pandemic waves from 2019 to 2020 (mood: 8.0% to 5.7%; behavioral: 5.6% to 3.4%; suicide-related: 1.0% to 0.7%; psychosis: 0.7% to 0.5%, respectively).
CONCLUSIONS: Prevalence of suicide-related and substance use diagnoses showed overall increases from 2017 to 2023 but experienced declines during 2020, reflecting potential pandemic-related disruptions. For incidence, sharp declines from 2019 to 2020 coincided with initial waves of COVID-19 infections and reduced access to care during the pandemic, particularly for Medicaid populations. Limited access to emergency care and MH service closures likely contributed to underdiagnoses. These findings highlight the importance of addressing healthcare disparities, improving access to MH services, and use of telehealth to ensure continuity of care during public health emergencies.
METHODS: This Texas Medicaid retrospective cohort study included adolescents 10-19 years from 2017 to 2023. Pre-existing MH diagnoses were excluded for incidence. Both incidence rate and period prevalence were calculated based on each individual year. Diagnoses (ICD-10 codes) included mood, behavioral, suicide-related, substance use, and psychosis. Descriptive and inferential statistics were employed.
RESULTS: Overall prevalence (Ns range: 1,550,281 to 1,874,542) increased from 2017-1019 (17.5% to 19.3%) and decreased from 2020-2023 (18.4% to 17.3%). Mood and behavioral diagnoses prevalence increased from 2017-2019 (6.7% to 8.2% and 9.1% to 9.2% respectively). Mood diagnoses plateaued in 2020 and then started to increase, while behavioral diagnoses declined after 2020. Suicide-related (0.5% to 0.7%) and substance use (0.8% to 0.9%) diagnoses increased steadily from 2017 to 2023, but substance use diagnosis declined in 2020 (0.7%) during the early COVID-19 waves. Overall incidence (Ns range: 806,425 to 1,054,537) decreased from 2017-1019 (17.7% to 16.5%) and continued from 2020-2023 (11.1% to 11.2%). Incidence of all diagnoses declined during the early pandemic waves from 2019 to 2020 (mood: 8.0% to 5.7%; behavioral: 5.6% to 3.4%; suicide-related: 1.0% to 0.7%; psychosis: 0.7% to 0.5%, respectively).
CONCLUSIONS: Prevalence of suicide-related and substance use diagnoses showed overall increases from 2017 to 2023 but experienced declines during 2020, reflecting potential pandemic-related disruptions. For incidence, sharp declines from 2019 to 2020 coincided with initial waves of COVID-19 infections and reduced access to care during the pandemic, particularly for Medicaid populations. Limited access to emergency care and MH service closures likely contributed to underdiagnoses. These findings highlight the importance of addressing healthcare disparities, improving access to MH services, and use of telehealth to ensure continuity of care during public health emergencies.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH79
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Mental Health (including addition)