How does the US provide mental health treatment?

More than one in five adults in the US — about 58 million people — lives with a mental illness. In 2021, 47.2% of them received some form of mental health service.

Women were more likely to get care: 51.7% of women with a mental illness received care, compared to 40% of men, according to the National Institute of Mental Health. And while younger people had higher rates of mental illness, they were less likely to receive care than older adults.

Among different races and ethnicities, Asian adults were the least likely to receive mental health services. In 2021, 25.4% received care, less than half the rate of white (52.4%) and multi-race adults (52.2%).

Why and how do people seek treatment for mental illness?

People can seek treatment for a variety of mental illnesses, including anxiety, depression, substance use disorders, and more. More than one in 20 Americans has a serious mental illness like schizophrenia, bipolar disorder, or major depression. The Substance Abuse and Mental Health Services Administration (SAMHSA) operates a national helpline that offers a free, confidential treatment referral and information service for individuals and families facing mental health and substance use disorders. FindTreatment.gov is an online federal resource that helps people locate nearby mental health treatment facilities.

Still, accessing mental health services can be a challenge: over one-third of Americans live in areas that lack mental health professionals.

Measuring who’s had a major depressive episode since 2005

About one in 12 adults had recently experienced a major depressive episode in 2021, according to SAMHSA data. This was a slight increase over a decade, though survey methodology changed in 2020, and SAMHSA says to compare new and old survey results with caution.

In 2021, one in five children between 12 and 17 years old had recently experienced a major depressive episode, according to SAMHSA estimates. The CDC warns that American teens are experiencing an ongoing mental health crisis, especially girls and LGBTQ+ youth.

Where and how do people with mental illness receive treatment?

People seeking mental health services can access care through inpatient treatment and counseling, outpatient treatment and counseling, or prescription medication. These health care options can help people treat issues related to emotions, nerves, or mental health. According to SAMHSA, early and consistent treatment is key to managing mental health conditions.

Why don’t people receive mental health care?

Cost remains the primary reason people don’t receive mental health care when they need it, according to SAMHSA data. In 2021, 40% of people with a perceived unmet need for mental health care said they didn’t get care because they couldn’t afford it.

Other reasons people reported for not receiving care included: not knowing where to receive it (30%), thinking they can handle the issue themselves (27.6%), thinking treatment wouldn’t help (12.1%), and not wanting others to find out (7.6%).

Settings for mental health services, by frequency over time

About 8% of US adults accessed outpatient mental health care in 2021. That includes care from private therapists, doctors offices, day hospitals and day treatment programs, school or university clinics, and outpatient medical clinics.

Private therapists, social workers, or counselors are the most common component of outpatient care. In 2021, more than 60% of people who received outpatient mental health care visited one of those professionals.

In recent decades, the use of prescription medication for mental health has increased: nearly 13.1% of adults used medication for a mental illness in 2019, up from 11.3% a decade prior.

How many people receive services for mental illness virtually?

More than 28 million adults, or 11.3%, accessed mental health services virtually in 2021. Almost half (49.7%) of all adults with a serious mental illness received virtual care, as did a quarter (25.6%) of adults with a non-serious mental illness, according to SAMHSA data. 2021 is the first full year SAMHSA tracked virtual access to mental health care.

If you are struggling with mental health issues, call the SAMHSA National Helpline, 1-800-662-HELP (4357), a free, confidential, 24/7, year-round treatment referral and information service. Or, call the 988 Suicide and Crisis Lifeline. If you are thinking about harming yourself or attempting suicide, tell someone who can help immediately and call 911.

Learn more about the mental health of young Americans, the lack of mental health services, and get the data directly in your inbox by signing up for our email newsletter.