Mental health, substance use, and other behavioral health care expenditures accounted for 40% of all health-related spending for U.S. children in 2022, according to a new study by researchers at the University of California, San Francisco (UCSF). This figure is nearly double what it was in 2011, highlighting a significant shift in family health budgets.
The study, published in JAMA Pediatrics, reveals that the costs associated with behavioral health care for children have increased more than twice as fast as those for other medical services. Families experienced an average annual increase of 6.4% in out-of-pocket spending on behavioral health, compared to a 2.7% rise for non-behavioral health care.
“Families are bearing growing costs,” said Dr. Ashley Foster, the study’s lead author and a pediatric emergency care physician at UCSF Benioff Children’s Hospitals. “As a country, we need to make sure behavioral health care is accessible and affordable for every family, regardless of insurance status.”
Understanding the Financial Impact
The researchers analyzed 11 years of national spending data from 2011 through 2022 for children aged 6 to 17. By 2022, behavioral health care accounted for $41.8 billion of overall health spending, with families contributing $2.9 billion—more than a quarter of their out-of-pocket health expenses—toward this type of care.
Having a child in need of behavioral health services significantly increases the financial strain on families. According to Dr. Foster, “Families with at least one child who has behavioral health issues are 60% more likely to face a high financial burden, and 40% more likely to have an extreme financial burden—meaning more than 10% of their family income goes toward that care.”
Exploring the Causes Behind Rising Costs
While the study did not specifically investigate the reasons for the increase in spending, the data provides some insights. Dr. Foster suggests that several factors may be contributing to the rise in costs, including an increase in the number of children experiencing behavioral health challenges, partly due to the COVID-19 pandemic, as well as rising costs per visit and improved access to care.
“Access has improved thanks to less stigma about mental health challenges and because there are more community-based care venues now,” Foster explained.
Shifts in Treatment and Care Delivery
The research also highlighted changes in how and where children receive behavioral health treatment. Spending on home health services surged by 25% per year, while in-person outpatient visits increased by 11% annually. Notably, the number of telehealth visits skyrocketed by 99% per year between 2020 and 2022, a trend that Dr. Foster believes is here to stay.
“Telehealth is here to stay,” she noted, emphasizing the growing role of digital health solutions in providing accessible care.
Implications and Future Directions
The findings underscore the urgent need for policy interventions to ensure that behavioral health care remains accessible and affordable for all families. As the demand for mental health services continues to rise, stakeholders must address the financial challenges faced by families and explore sustainable solutions.
Meanwhile, UCSF Benioff Children’s Hospitals, recognized among the nation’s leading pediatric specialty hospitals, continue to advance research and clinical practices to improve care for children with behavioral health needs. Their efforts are part of a broader commitment to translating research into effective interventions for pediatric diseases.
As families navigate these financial challenges, the study serves as a call to action for policymakers, healthcare providers, and communities to work collaboratively to support the mental well-being of children across the nation.
