Millennial Mental Health and Finances

By: Greenwald Research
6/15/2023What care do they need? How can they get it? How do they pay for it?

Pandemic-induced social and professional isolation and disruptions have sparked a national conversation about mental health care. Demand for services has increased – especially among younger generations – while we’re facing a nationwide shortage of mental health providers.

At Greenwald Research, we wondered how the greater need for – and reduced accessibility of – mental health care is impacting Millennials, who are now in their prime working years for creating long-term financial security. Their stage of life also includes major events like purchasing a home, saving for retirement, or starting a family. So we conducted an online survey of 543 privately insured Millennials to better understand their need for mental health care, the barriers they face in accessing that care, and how paying for those services impacts them financially.

What we found is concerning. Insurance companies need to make improvements in delivering mental health services to head off a potential crisis.

Millennials are not in the best of health, physically or mentally

• Millennials rate their own health worse than the national average. Just 44% of respondents rate their overall health as excellent or very good. Compare that to CDC statistics, where 52% of Americans rate their own health as excellent or very good.
• What’s worse, Millennials rate their mental health as worse than their physical health. Just 36% say their emotional or mental health is excellent or very good, and nearly as many – 32% — say their mental health is fair or poor. That’s twice as many who report fair/poor overall health.
• Millennials’ need for emotional or mental health care is high: 55% of respondents report they have needed mental health services in the past year.
• Use of mental/behavioral health services is high, even among those who say they don’t need those services. 79% say they saw a mental health/behavioral professional in the past year (including 60% of those who don’t specifically say they need the care). Of those who saw a professional, 30% say their primary professional is a therapist, 25% their primary care physician, and 21% a psychiatrist.

Finding and Paying for Mental Health Services

Health insurance companies – and in particular, their websites – play an important role in accessing and finding care among Millennials. And it’s clear that mental health and finances are intrinsically linked – getting an in-network professional can make a huge difference in cost, satisfaction with services, and ability to cope with finances overall.

• Of those who say they’ve seen a mental health professional, 74% see an in-network professional as their primary mental health provider. 19% see an out-of-network professional but get partial reimbursement from their health plan. Those with employer-sponsored health insurance are more likely to see an in-network professional. We hypothesize that those purchasing their own health insurance plans would tend to purchase less rich plans, leaving fewer in-network options.
• 95% say their provider being covered by their health insurance is important, indicating a strong preference for insurance providers to expand coverage in the mental/behavioral health sphere. This preference is especially strong among women, who tend to have lower salaries than men.
• Millennials are surprisingly reliant on their health care insurer’s website to find care. 68% say they use Google searches when trying to find a professional, but an almost equal number (66%) use their health insurer’s website as a primary source of information. White, Hispanic, and college-educated Millennials tend to be most reliant on their health insurer’s website.
• Those in fair or poor mental health are most likely to say it was difficult to navigate their health insurer’s website (37%) – so those most in need of help are less likely to receive it. They say they want more clarity on those websites, with 21% calling for a clearer listing of providers and 16% wanting more detail for each provider listed.
• The majority of privately insured Millennials feel financially insecure and are carrying significant debt. 71% of respondents say thinking about finances causes a great deal of stress and 68% say they have very little money left after monthly expenses. The most common types of debt they report are credit card debt (57%), mortgage (32%), car purchase (31%), medical debt (30%), and student loans (25%). Only 18% say they have no debt.
• Lack of adequate finances has a strong impact on use of medical care: 51% of respondents say they’ve delayed some sort of care in the past year due to cost. 28% have delayed appointments for non-mental health care, while 17% have delayed therapy appointments.

Conclusions & Takeaways

Insurers can foster loyalty and keep high-cost claims down overall by having robust in-network behavioral health: a stronger network means more clients. To pay less for care, fully 72% of respondents who see out-of-network professionals say they would likely switch to an in-network professional, with 29% saying they are very likely to do so.

Mental health is tied to physical health, and mental health for Millennials is poorer than for the population as a whole. When people are unable to care for their mental health, it has deleterious effects on their physical health, which can lead to overuse and misuse of urgent care centers and emergency rooms or claims that are higher cost than they might have been otherwise. Providing access to mental health care is essentially providing preventive care that will both keep costs down and improve the overall health of their members.

Having an easily navigable, clear, and detailed website can make a powerful difference in finding mental health care, especially for those most in need of support and services. Fairly simple changes like clearer lists of providers with greater provider detail can make a big difference in finding the right fit, or indeed any professional at all.

Specialization is important and can make the difference in receiving care. Those in most need of help are more likely to say that having a provider who specializes in their specific condition is important, and given the high prevalence of specific diagnoses in this population, insurance providers need to ensure that a wide range of professionals is available. Those who need mental health care may be struggling to find the right fit for them or may even be forgoing care if they are unable to find a professional who specializes in their condition.

Those who see in-network professionals are more satisfied with their care, while those who see behavioral health professionals out-of-network are willing to switch to in-network professionals if there are options available. This opens the door for insurers to provide coverage that may differentiate them from their competitors. It also is an opportunity to build loyalty among their members by providing them with affordable care that is critical to their overall health.

Lack of choice or inability to find care is an equity issue that has a cascading effect on personal finances and healthcare costs. It has been well known that mental health has a deleterious effect on finances, and our study shows that this holds true for Millennials. Those with mental health issues are more likely to view their finances negatively, have debts, and delay their medical care due to finances. Those who can’t afford to look elsewhere have less of a chance finding the right fit they need, which affects personal finances and eventual health care costs. Health insurance companies can help those with greater financial and mental strains get the care they need, which can then have positive repercussions for everyone.

Millennials are in a unique position: they are of prime working age, but middle age is just around the corner. While mental health needs are high, there are clear ways that health insurance companies can aid Millennials, a key part of their customer base, and benefit not only Millennials but themselves and the health care industry as well.