National and State Level Trends in Mental Health and Substance Use Disorder Visit Rates at FQHCs, 2012-2019

National: From 2012 to 2019, MH visits grew from 82 to 359 per 1k population with a BH condition, a 4.4-fold relative growth. SUD visits grew from 15 to 59 per 1k population, a 3.9-fold growth. Combined, FQHC BH visits grew from 97 to 418 visits per 1k population with any BH condition, a 4.3-fold growth. MH FQHC patients had a 4.4-fold relative growth and SUD patients had a 3.9-fold growth from 2012-2019. The number of visits per year for someone with a mental health condition increased from 3.0 to 3.3, SUD visits decreased from 4.3 to 4.2, and BH increased from 3.2 to 3.4.

State: The states (or DC) with the highest BH visit rates in 2019 were DC (2,132 per 1k), VT (1,666 per 1k), and NM (1,606 per 1k) and the states with the lowest rates were DE (122 per 1k), NJ (129 per 100k), and NV (130 per 100k). The states with the largest proportional increase in BH visit rates from 2012 to 2019 were WY (2019:2012 ratio of 5.5), NV (5.4), and OH (5.3); the states with the lowest proportional increase in BH visits rates were AK (0.7), OR (1.1), and HI (1.2).

Conclusions: Between 2012-2019, FQHCs throughout most of the US increased its BH visits at a rate that outpaced the growth in BH condition prevalence. Most of this growth is attributable to an increase in MH visits, although SUDs did experience more modest growth. This growth is explained by FQHCs caring for a large share of patients with BH conditions, rather than increasing visit intensity for existing BH patients.