Trilliant Report Details Impact of Behavioral Health Demand Surge

Analytics and market research firm Trilliant Health has released a report signaling that the behavioral health crisis has intensified in the years following the COVID-19 pandemic, with demand surging 62.6% since 2018.

Between 2018 and 2024, behavioral health utilization increased to 1,346 visits per 1,000 people. Anxiety disorders saw the highest utilization and fastest growth during this time (+89.3%), with utilization concentrated among women ages 18-44. Among children, demand is increasingly driven by pervasive developmental disorders (e.g., autism), speech and language disorders and anxiety.

“The data in this report tells a story that is impossible to dismiss,” said Trilliant Health Chief Research Officer Allison Oakes, Ph.D., in a statement. “Behavioral health in the U.S. is not a peripheral concern, a niche service line or a problem on the horizon. It is America’s preeminent public health challenge, shaping utilization, mortality, the healthcare workforce and the financial performance of the health economy as well as the economy at large.”

Here are some bullet-point highlights from the in-depth report: 

• Rising mortality underscores the consequences of unmet behavioral health demand. Drug- and alcohol-induced deaths have increased 176.1% since 1999, with mortality more than doubling across every adult male age cohort. Increases are most pronounced among men ages 65–84 (+118.7%). Intentional self-harm accounted for 48,824 deaths in 2024, the tenth-leading cause of death in the U.S., with rates among adolescent males increasing 45.2% since 2004.

• Stimulants (+53.3%) and antipsychotics (+45.4%) led growth in behavioral health prescribing. The stimulant surge was driven by  women, with patient volumes increasing by 93.6% among women ages 18-44, 69.6% among older women and by 30.4% in children. Anxiolytics, the highest volume medication class, saw the largest growth among men ages 18–44 (39.6%).

• Telehealth accounts for two-thirds of behavioral health visits, yet workforce shortages and care gaps persist. The national mental health professional adequacy rate stands at just 27.3%, with projected shortfalls of 36,780 FTEs in adult psychiatry and 99,780 in mental health counseling by 2038. More than half of patients presenting to the ED for anxiety (53.1%) or substance use disorder (51.2%) did not receive specialized follow-up care within 30 days.

• Care costs vary up to 7x by setting and provider. Untreated mental illness cost $477.5 billion in 2024 and is projected to exceed $1.3 trillion annually by 2040. Financial barriers to care remain significant: negotiated rates for group and individual psychotherapy vary by as much as 7x. This variation contributes to inconsistent access and unnecessary spending.

Healthcare Innovation recently interviewed Oakes about a Trilliant report noting the association between the use of AI scribing tools and an increase in high-intensity outpatient billing codes across six health systems.