There is an untapped opportunity for stakeholders across the industry to improve care for women with anxiety disorders and depression. Anxiety disorders affect a third of U.S. women every year, yet only half of those affected received care — with notable socioeconomic disparities in care-seeking behaviors and likelihood of receiving treatment. Among those who reported needing treatment for these conditions, a higher proportion of white women (62%) sought care than Black (59%), Hispanic (56%), or Asian/Pacific Islander (50%) women. We interviewed 16 healthcare leaders who shared opportunities for stakeholder groups to improve care for anxiety disorders and depression with high chance of efficacy. And the opportunity to act isn’t limited to providers. Health plans, digital health companies, pharmaceutical companies, and policymakers can also effect change.

66% of individuals affected by anxiety disorders and depression are women

34% of U.S. women report experiencing emotional distress in the past two years, compared to 11% of women in France and 20% of women in the United Kingdom

45% of women with a lifetime incidence of any anxiety disorder also have an additional anxiety disorder, compared to 34% of men

55% of U.S. women who are <200% below the federal poverty level (FPL) report the need for behavioral healthcare, yet most of those who seek treatment are above the FPL

37% of U.S. women are unable to schedule an appointment for behavioral healthcare within a month of contacting a provider, and 16% are unable to get an appointment at all

33% of U.S. women who seek care for their mental health are unable to get an appointment because of the cost of service

Anxiety disorders and depression are prevalent, but there are significant barriers to care, including high costs, lack of available providers, and limited coverage for appropriate services. There are many opportunities to improve care options, such as incentivizing behavioral health professionals who specialize in these conditions, removing financial barriers to care, and improving access to behavioral health resources. To ensure women are well equipped to address anxiety disorders and depression, providers and health plans should prioritize finding solutions to better cover medical and behavioral treatments. Employers should design employee benefits packages to include services that address anxiety disorders and depression.

No organization can solve for women’s health inequities on its own. But every organization has a role to play in dismantling inequities in women’s care delivery to improve outcomes. Below are some initial steps for those with the greatest potential to make a difference in care for anxiety disorders and depression.

Provider organizations

• Reduce financial barriers to care by accepting commercial insurance for common treatments for depression and anxiety. One-third of U.S. women who sought mental healthcare were unable to schedule an appointment because they couldn’t afford the cost.
• Train ob/gyns to assess patients for anxiety disorders and depression. Fewer than half of ob/gyn programs in the U.S. cover non-obstetric depression (44%) or anxiety (43%), and most program directors feel that ob/gyn residents are not fully equipped to identify psychiatric needs in patients.

Health plans

• Expand coverage and networks for behavioral health services. Private health plans can partner with employers to improve access to care through specialized offerings like Employee Assistance Programs. Medicaid programs can improve their preferred networks of behavioral health providers for members.

Digital health companies

• Provide innovative solutions for connecting patients to virtual behavioral health and wellness services. Given that the majority of telehealth users are women, digital resources are key to addressing their challenges with anxiety disorders and depression. Solutions can include virtual therapy and counseling services, connections to resources, and digital communities for people experiencing anxiety disorders and depression.

Kaiser Permanente California (2022)

• Kaiser Permanente (KP) is a California-based integrated managed care system — the largest in the United States.
• From 2017-2018, KP launched a depression screening program among breast cancer patients using a standardized nine-item patient health questionnaire (PHQ-9). The implementation strategy involved training providers to screen for depression and offering regular feedback on their performance.
• The intervention resulted in a 7.8% increase in referrals for depression screening. Additionally, 75% of patients who received treatment at an intervention site completed referrals to a behavioral health clinician.