Key Insights

• The Blue Cross Blue Shield Association (BCBSA) released a follow up to their 2019 millennial mental health trends study that examines how COVID-19 has affected previous results.
• The new study shows that among all previous patient populations, like Generation X and Baby Boomers, millennials have been the most impacted by COVID-19 and are more likely to suffer from chronic conditions in the future.
• The study shows a positive trend in the number of millennial patients who feel comfortable seeking help for their mental health conditions.

In 2019, the Blue Cross Blue Shield Association published a study detailing health trends in millennial patients. Millennial patients, defined in the study as commercially insured “people born between 1981 and 1996 and who were 21 to 36 years old in 2017,” are “facing health challenges at earlier ages than previous generations.” The study showed that millennials experienced a “major decline in health” as early as age 27.

Of the top ten health conditions, six are related to mental health and substance abuse, while others were physical conditions, including high cholesterol, Crohn’s disease/ulcerative colitis, and hypertension. The study found that between 2014 and 2017, millennials experienced a 31 percent increase in prevalence of major depression, as well as a 22 percent increase in rates of type 2 diabetes. Additionally, millennials were impacted by “double-digit increases” in the prevalence of substance use disorders, psychotic conditions, hypertension, and high cholesterol.

In 2020, the BCBSA study revisited these results during the COVID-19 pandemic and determined that COVID-19 had exacerbated certain conditions. More specifically, millennial patients have reported a 34 percent increase in alcohol consumption and an overall increasing rate of substance abuse.

Trending Attitudes Toward Mental Health

Unlike previous generations, millennial patients do tend to take a holistic approach to mental health. BCBSA’s new study shows that 80 percent of millennials believe their mental health impacts their physical health.

Millennials are also embracing a new approach to seeking treatment. Along with Generation Z, millennials are more likely to report their mental health symptoms and seek treatment for them. This is also true with opioid use disorder (OUD); BCBSA’s study found “nearly two thirds of millennials diagnosed with OUD received treatment in 2018 compared to less than half of Gen Xers and less than a third of Baby Boomers with an OUD diagnosis.”

What This Means for Clinicians

Clinicians who are seeing millennial patients during the COVID-19 pandemic may find increased rates of substance use and mental health disorders.

Engaging with and discussing mental health disorders with millennials of color is especially important. BCBSA’s study found that in millennials diagnosed with an OUD, those “in majority Black or Hispanic communities have substantially lower rates of treatment across all treatment types compared to millennials in majority white communities.”

Growing demand for behavioral health resources will exacerbate the existing shortage of these services and drive up healthcare costs. BCBSA’s 2019 study found that increasing rates of mental health conditions “will likely have substantial effects on the American economy over the next two decades — including workplace productivity and healthcare costs.” Increasingly, primary care physicians and providers must coordinate their patients’ care with mental health specialists to improve patient outcomes.

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