The U.S. healthcare system has been reshaped by the pandemic in ways that continue to ripple through nearly every specialty. While primary care, urgent care, and surgical centers are still seeing significant drops in patient volume, one area has surged ahead: behavioral health. According to a comprehensive report from Trilliant Health, Behavioral Health Utilization Trends show that visit volumes are 16.8% above pre-pandemic levels, while other healthcare services remain 6.2% below.
This contrast tells an important story about where Americans are placing their priorities post-pandemic. The demand for behavioral health reflects both the lasting emotional toll of COVID-19 and a broader cultural shift toward openly addressing mental health challenges. At the same time, the decline in preventive screenings, primary care visits, and other essential health services raises red flags about what this imbalance could mean for long-term public health.
The Uneven Recovery of Healthcare Utilization
While the early months of the pandemic caused sharp declines in nearly all healthcare visits, recovery has not been evenly distributed. Trilliant Health describes what much of the industry is experiencing as an “illusory volume rebound.” In other words, the bounce-back in visits for many specialties is not strong enough to offset what was lost.
Patients who skipped screenings, surgeries, or routine care during 2020 and 2021 often did not reschedule — meaning that for many, care was not simply delayed, but foregone altogether. This trend has been particularly evident in preventive care, where early detection of chronic conditions is being compromised by reduced visit volumes.
By contrast, Behavioral Health Utilization Trends buck the pattern. The heightened stress, isolation, and uncertainty of the pandemic drove more people to seek therapy, psychiatric care, and medication management. Visits peaked at 81 million in Q2 2021 and remained strong with 79.5 million in Q1 2022, showing sustained demand even after the most intense pandemic phases.
Regional Shifts: Why Some Metros Grew While Others Declined
The Trilliant Health report highlights that behavioral health demand has been far from uniform across the country. Of the metros studied, 69.5% saw increases in utilization, with an overall average increase of 14.1%. However, the extremes paint a more complex picture.
- Largest Increases: Rochester, New York saw the sharpest rise, with a 60.3% increase in behavioral health visits compared to pre-pandemic levels. This spike reflects localized Behavioral Health Utilization Trends where strong community awareness and service availability align.
- Largest Decreases: The Urban Honolulu, Hawai’i metro recorded a 30.2% decline, while Texas metros such as San Antonio-New Braunfels (-21.1%) and Houston-The Woodlands-Sugar Land (-1.9%) also experienced drops.
These disparities suggest that access to services, cultural attitudes toward mental health, and local healthcare infrastructure all play significant roles in Behavioral Health Utilization Trends.
Demographic Trends: Who Is Seeking Care?
One of the most striking findings from the report is the variation in utilization by gender, age, and insurance type.
- Gender Differences: Women increased their utilization of behavioral health services by 26.2%, nearly four times the rate of men. This may reflect deeper cultural Behavioral Health Utilization Trends, as women are often more proactive in seeking care.
- Age Groups:
- Ages 18 to 64 saw the largest increase at 25.4%, reflecting the unique pressures placed on working-age adults during the pandemic.
- Ages 17 and under grew 7.4%, while ages 65 and older saw only 5.6%, pointing to generational divides in utilization.
- Insurance Type: Commercially insured patients drove much of the increase, up 24.2%, while Medicaid saw an 11.8% increase and Medicare a 1.5% decline.
These findings show that Behavioral Health Utilization Trends differ dramatically depending on demographic and economic circumstances, underlining the need for tailored solutions.
Telehealth: A Lifeline for Behavioral Health
One of the most important drivers of behavioral health demand has been telehealth. During the height of the pandemic, telehealth was rapidly adopted across nearly all specialties. However, while usage has since declined significantly for most areas of care, it has remained steady for behavioral health.
In Q1 2022, 59.9% of all telehealth visits were for behavioral health reasons, compared to just 32.4% in 2019. Patients and providers alike have found telehealth particularly well-suited for therapy and psychiatric care.
Telehealth has become deeply intertwined with Behavioral Health Utilization Trends, helping bridge access gaps, especially for individuals in rural or underserved areas. It has made care more consistent and accessible while keeping demand high even after broader telehealth adoption declined.
The Rise of Behavioral Health Prescriptions
Closely tied to the increase in behavioral health visits has been a rise in prescriptions for mental health medications. In 2021, antidepressant and antianxiety drugs accounted for 18.9% of prescriptions in a selected set of seven drug classes, surpassing opioids (15.4%) for the first time.
This marks another evolution in Behavioral Health Utilization Trends, where patients are not only engaging more in therapy but also relying on pharmacological interventions. The seven drug classes analyzed totaled about 98 million prescriptions, illustrating how behavioral health needs are reshaping pharmaceutical demand.
Challenges for the Broader Health Economy
While behavioral health demand has surged, the broader health economy is facing mounting challenges. The Trilliant Health report points to several concerning trends:
- Decline in Commercially Insured Patients: Commercial insurance has long been the financial backbone of the healthcare system. A decline in this group creates financial strain for providers.
- Rise of Retail Healthcare Giants: Amazon, CVS, and Walmart are entering the market, commoditizing services and influencing Behavioral Health Utilization Trends indirectly by shifting where and how people seek care.
- Pressure on Reimbursement Models: With potential reimbursement caps and systemic financial pressures, providers are navigating a delicate balance.
What This Means for the Future of Care
The rise in behavioral health demand is a double-edged sword. On one hand, it reflects positive cultural progress: more people are seeking help, stigma is declining, and telehealth is enabling access. On the other hand, uneven Behavioral Health Utilization Trends reveal ongoing disparities in access, as well as the financial vulnerabilities of the healthcare system overall.
For providers, this moment represents both a challenge and an opportunity. Meeting the surge in demand will require expanded capacity, innovative care models, and a focus on equity. For policymakers, the findings highlight the urgent need to support behavioral health infrastructure with sustainable funding and workforce solutions.
Key Takeaways
- Behavioral Health Utilization Trends show visits are up 16.8% above pre-pandemic levels, while other healthcare services are down 6.2%.
- Visits peaked in 2021 at 81 million and remain strong in 2022.
- Regional differences are wide, with Rochester, NY showing a 60.3% increase and Urban Honolulu a 30.2% decline.
- Women, working-age adults, and commercially insured patients are driving demand.
- Telehealth remains central, with nearly 60% of telehealth visits tied to behavioral health.
- Prescriptions for antidepressants and antianxiety medications are rising, surpassing opioids in 2021.
- The broader health economy faces pressure from declining commercial insurance, retail competition, and reimbursement challenges.
Conclusion
The pandemic reshaped the healthcare landscape, but nowhere has the shift been more profound than in behavioral health. Strong and sustained demand, changing demographics, and the rise of telehealth are defining Behavioral Health Utilization Trends in ways that will influence the industry for years to come.
For healthcare leaders, the path forward lies in embracing these trends, expanding access, and ensuring equitable care delivery. As behavioral health becomes a central pillar of the healthcare system, understanding and adapting to these utilization patterns will be critical for building a more resilient and responsive future.
