More than half of U.S. adults with a mental illness do not receive treatment
There were 52.9 million U.S. adults aged 18 or older in 2020 with a mental illness in the past year.
"46.2 percent (24.3 million people) received inpatient or outpatient mental health services or took prescription medication to treat a mental health condition in the past year."
This means that more than half of U.S. adults with a mental illness did not receive services or medication.
But only a fraction of those people who did not receive treatment perceived that they had an unmet need, as determined by their responses to a survey question that asked them "whether there was any time in the past 12 months when they thought they needed treatment or counseling for mental health issues but did not receive services."
"30.5 percent (or 16.1 million people) perceived an unmet need for mental health services in the past year."
These are the top three reasons for not receiving mental health services (among adults aged 18 or older in 2020 who had mental illness in the past year and a perceived unmet need for mental health services but did not receive services in the past year):
Could not afford the cost of care (44.9 percent for these adults with AMI)
Not knowing where to go for services (32.7 percent for these adults with AMI)
Believing they could handle the problem without treatment (29.7 percent for these adults with AMI)
Data
In October 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) published a report, Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.
You can find a PDF of the report here.
On pages 41 to 47 of the report, there's a section about "Mental Health Service Use in the Past Year."
The survey included questions to estimate "the use of mental health services among the overall adolescent and adult populations" and "the use of mental health services among adolescents and adults with mental health issues (i.e., MDE, AMI, and SMI)."
Acronyms defined:
MDE stands for “major depressive episode.”
AMI stands for “any mental illness.”
SMI stands for “serious mental illness.”
These are the sections of the report cited in this article:
Mental Health Service Use among Adults
Receipt of Inpatient or Outpatient Mental Health Services or Prescription Medication among Adults
Receipt of Inpatient or Outpatient Mental Health Services or Prescription Medication among Adults with AMI
Perceived Unmet Need for Mental Health Services among Adults with Mental Illness
Perceived Unmet Need for Mental Health Services among Adults with AMI
Reasons for Not Receiving Mental Health Services among Adults with Mental Illness and a Perceived Unmet Need
Mental Health Service Use among Adults
“Adult respondents aged 18 or older were asked whether they received treatment or counseling for any problem with emotions, ‘nerves,’ or mental health in the past year in any inpatient or outpatient setting or if they used prescription medication in the past year for a mental or emotional condition.”
Receipt of Inpatient or Outpatient Mental Health Services or Prescription Medication among Adults
"In 2020, 16.9 percent of adults aged 18 or older (or 41.4 million people) received inpatient or outpatient mental health services or took prescription medication in the past year for a mental health issue."
0.9 percent (or 2.2 million people) received inpatient services.
8.8 percent (or 21.5 million people) received outpatient services.
13.8 percent (or 33.8 million people) took prescription medication.
Note: the population for the data in this section is total U.S. adults, regardless of whether they have a mental illness.
Receipt of Inpatient or Outpatient Mental Health Services or Prescription Medication among Adults with AMI
"Among the 52.9 million adults aged 18 or older in 2020 with AMI in the past year, 46.2 percent (or 24.3 million people) received inpatient or outpatient mental health services or took prescription medication to treat a mental health condition in the past year."
Note: the population for the data in this section is U.S. adults with any mental illness (AMI).
Perceived Unmet Need for Mental Health Services among Adults with Mental Illness
“Perceived unmet need for mental health services among adults is estimated from a question that asked all adults aged 18 or older whether there was any time in the past 12 months when they thought they needed treatment or counseling for mental health issues but did not receive services.”
“The section also discusses the reasons adults with AMI or SMI did not receive these services in the past year if they had a perceived unmet need.”
Perceived Unmet Need for Mental Health Services among Adults with AMI
“Among the 52.9 million adults aged 18 or older in 2020 with AMI in the past year, 30.5 percent (or 16.1 million people) perceived an unmet need for mental health services in the past year.”
“Among these 16.1 million adults with AMI and a perceived unmet need for mental health services, 48.0 percent (or 7.7 million people) did not receive any mental health services in the past year.”
Reasons for Not Receiving Mental Health Services among Adults with Mental Illness and a Perceived Unmet Need
"Among adults aged 18 or older in 2020 who had mental illness in the past year and a perceived unmet need for mental health services but did not receive services in the past year," these are the most common reasons for not receiving services:
Could not afford the cost of care (44.9 percent for these adults with AMI and 49.5 percent for these adults with SMI)
Not knowing where to go for services (32.7 percent for these adults with AMI and 33.5 percent for these adults with SMI)
Believing they could handle the problem without treatment (29.7 percent for these adults with AMI and 25.0 percent for these adults with SMI)
Conclusion
In 2020, 16.1 million U.S. adults with a mental illness did not receive treatment or counseling for mental health issues when they needed it.
It's unlikely that this situation has improved recently, as demand for therapy increased during the pandemic and there's a shortage of therapists.
(1) Cost and (2) not knowing where to go for services were the top two reasons why people did not receive services.
In order to provide more people with the mental health care they need, what can we do to lower the cost and educate people on where to go for mental health services?
Source
Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
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