Behavioral Health Service Use Among Medicaid and CHIP Enrollees Before/During the COVID-19 Public Health Emergency

In 2020, 53 million adults in the United States had a mental health condition and 40 million people ages 12 and older had a substance use disorder (SUD). The COVID-19 public health emergency (PHE) exacerbated mental health conditions and SUDs at a time when access to in-person care was restricted due to safety concerns. This brief examines the extent to which the PHE was associated with changes in the use of mental health and SUD services--hereafter referred to as behavioral health (BH) services--among 2 groups of Medicaid and Children’s Health Insurance Program (CHIP) enrollees: (1) those initiating treatment for BH conditions; and (2) those already receiving BH treatment (in the previous year). The COVID-19 PHE was associated with a decline in the initiation of treatment for BH conditions among Medicaid and CHIP enrollees. This decrease was driven by fewer children initiating treatment for a BH condition during the PHE--about one-quarter less than the year before. Those already receiving BH treatment may not continue treatment for a variety of reasons. During the PHE, there were small declines in the percentage of Medicaid and CHIP enrollees who continued BH treatment compared to before the PHE, but these changes were not substantial. Although fewer enrollees initiated or continued BH treatment overall during the PHE, the reductions were largest for children and Black and Hispanic enrollees.

This research was compiled and funded by the HHS/ASPE Office of Behavioral Health, Disability, and Aging Policy (BHDAP).  Additional research in this area is available at the ASPE Behavioral Health page. 

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Brenda Veazey, brenda.veazey@hhs.gov. Content will be updated pending the outcome of the Section 508 review.

Available Reports:

• Behavioral Health Service Use Among Individuals Enrolled in Medicaid and CHIP Before and During the COVID-19 Public Health Emergency Issue Brief

Related Resources:

• Racial/Ethnic Differences in Children’s Mental Health Services Use Before and During the COVID-19 Pandemic Issue Brief (2022)
• Child and Adolescent Mental Health During COVID-19: Considerations for Schools and Early Childhood Providers Issue Brief (2021)
• Mental Health Consequences of COVID-19: The Role of Social Determinants of Health Research Brief (2021)