Defining behavioral health
Mental health. Resilience. Well-being. All of these terms describe what health care professionals refer to as “behavioral health."1
Promoting behavioral health involves the prevention, diagnosis and treatment of a broad range of needs, including mental health conditions, substance use disorders, life stressors and crises, stress-related physical symptoms and much more.2 These needs exist on a spectrum of severity and complexity—from higher-acuity conditions like autism and schizophrenia, to lower-acuity conditions like stress and anxiety.
Behavioral health plays a vital role in overall health and wellness due to its deep connection to physical health. Failing to address unmet needs can have dire consequences—not just on health outcomes, but also on total health care costs.
1. Substance Abuse and Mental Health Services Administration (SAMHSA). “Behavioral Health Integration”. https://www.samhsa.gov/sites/default/files/samhsa-behavioral-health-integration.pdf
American Medical Association (AMA). (2022).
2. “What is behavioral health?” https://www.ama-assn.org/delivering-care/public-health/what-behavioral-health
The need for care is rising, along with spend
increase in prevalence for behavioral health conditions from 2018–2023.4
4. Cigna 2018- 2023 Commercial and IFP BOB data, with medical, behavioral and pharmacy continuous coverage over the year. The prevalence of antidepressants has increased among all ages and genders. Females continue to have a higher use.
increase in behavioral health spend.4
4. Cigna 2018- 2023 Commercial and IFP BOB data, with medical, behavioral and pharmacy continuous coverage over the year. For individuals with behavioral conditions, 65-75% of total spend is driven by medical spend.
Patients are experiencing delays in care
of adults with a behavioral condition also suffer from Physical health conditions- with costs up to 6X higher5
5. Evernorth Behavioral Health Insights, Book of Business claims data 1-1-20 through 12-31-20. Adults only. Results may vary.
of adults with a mental health condition never receive treatment.6
6. Mental Health America (MHA). “Access to Care Data 2023”. [Data set]. https://mhanational.org/issues/2023/mental-health-america-access-care-data
of patients get their behavioral medications from non-behavioral providers where a connection to therapy may not exist.7
7. ESI BOB insights 2023
Behavioral health by the numbers
Our vast, integrated data from across the health care system shows where gaps in care are most prevalent, helping us to identify who needs help the most.
More young individuals need care, but many may not be getting the care they need
Two in five youths with a mental health diagnosis did not receive treatment within six months of their initial diagnosis.8
of parents said their child was being treated with medication only.8
increase in young people with mental health diagnosis.8
increase in those with at least two mental health diagnoses.8
8. For a healthy workforce, curbing the youth mental health crisis is imperative (Evernorth Research Institute, 2024)
Tackling youth mental health is imperative
Eva Borden, President of Behavioral Health,
Evernorth Health Services
Additionally, we’ve found that members living in areas of higher social need—as scored by the Evernorth Social Determinants Index (ESDI)—are nearly 10% less likely to receive treatment than members in areas of lower social need. We can harness this data to identify and engage members who are experiencing gaps in care and guide them to the right resources for their needs.
* Claims were based on a 12-month period from January 1, 2023 through December 31, 2023 for customers with continuous medical, behavioral and pharmacy eligibility. Behavioral diagnoses were defined as any International Classification of Diseases 10th Revision (ICD-10) code starting with Fxx.xx within the first 5 diagnosis cTode fields on a medical or behavioral claim, excluding nicotine only and including suicide & self-harm.
Advancing health equity
Evernorth is committed to identifying disparities in health and driving greater access to behavioral health treatment.
Visit our Health Equity Hub to see how disparities in health can impact your members.
Closing the behavioral health gap
At Evernorth® Health Services, we take a data-informed approach to care and provide personalized support across the entire behavioral health continuum for the populations we serve.
Learn more about our comprehensive, cost-saving approach to behavioral care.
Our solutions help members achieve better mental health and emotional well-being by leveraging sophisticated identification models to proactively engage, swiftly navigate to the right level of care and deliver quality health outcomes that drive cost savings for both members and plans.
