More Americans want mental health treatment. But that doesn't always mean they receive it.
May is Mental Health Month, and people are taking wellness seriously. But what does the research say about people’s experience with mental health and obtaining high-quality care? While desiring mental health care is common among Americans, cost, coverage, wait times, and geography currently hamper many as they seek care.
Awareness campaigns are working, and stigma towards mental health conditions may be declining
According to a 2018 national survey of adults (age 18+) by Ketchum Analytics, 76% of Americans believe that mental health is just as important as physical health. What’s more, trends show that acceptance of mental health conditions is becoming stronger over time. Americans also seem to support prioritizing mental health more than we currently do: the same Ketchum survey found that 55% of respondents agreed that there must be a “fundamental shift in society” toward prioritizing mental health.
Millions still lack access to treatment
According to the National Institute of Mental Health, there were nearly 50 million American adults with a mental illness in 2017, or nearly 20% of the adult population. However, just over 40% of adults with a mental illness received treatment. The numbers become even more concerning when we consider racial disparities in treatment access—according to NIMH, 48% of White adults with a mental illness received treatment, compared to 32.6% of Latino adults, 30.6% of Black adults, and just over 20% of Asian adults.
The data from NIMH are similarly troubling when it comes to the subset of mental illnesses referred to as “serious mental illness,” including conditions such as schizophrenia, bipolar disorder, or major depression. Among the estimated 11.2 million adults with a serious mental illness in the U.S., a full third did not receive treatment for their condition in 2017. Again, disparities exist: while more than 70% of Whites with serious mental illness received treatment, that proportion drops to 56% among Latino and Black Americans.
People who seek treatment tend to be slightly younger and have lower incomes—and to be veterans
According to the recent Ketchum survey, there is great demand for mental health services—more than 140 million Americans, or over half of adults, “have sought or wanted to seek [mental health] treatment for themselves or others.” They are:
Somewhat more likely to be Millennials
More likely to have an annual household income below $50,000
More likely to be involved with the military, either directly or as family members.
According to that same survey, however, adequate access to treatment is a different story: 55% of those in high-income households considered mental healthcare “extremely accessible,” while only 42% of those in low-income households agreed.
Fewer Americans from low-income households think mental healthcare is “Extremely accessible” compared to those in mid- and high-income households
Treatment-seekers face both personal and institutional barriers to access
In a recent survey of the literature, Rand Corporation found that those in need of services often avoid seeking help for personal reasons, including: a belief that they can manage symptoms on their own, a preference for receiving support from trusted loved ones as opposed to trained professionals, or a perceived lack of time to pursue treatment. However, Rand also noted substantial systemic barriers to receiving mental health care, including a lack of information about where to turn for help, lack of insurance, few or no nearby providers, or inability to afford care.
Landmark legislation has begun to expand access, but not across the board
Two main pieces of federal legislation have tried to make mental healthcare more accessible: the Mental Health Parity and Addiction Equity Act was signed into law in 2008, requiring that health insurance plans offer “mental health and substance use disorder benefits that are comparable to their coverage for general medical and surgical care.” This was meant to prevent large group and employer-sponsored plans from charging higher rates and copays for mental health care. Shortly after, the Affordable Care Act applied similar provisions to individual plans.
While it is difficult to prove causation, there are reasons for cautious optimism regarding expansion of treatment. While treatment rates for those age 26 and above remained statistically unchanged, young adults saw gains. Among those age 18-25 with any mental illness, treatment rates improved by more than 8 percentage points between 2008 and 2017.
Innovative new ideas offer reasons for optimism
Some organizations are responding with innovative practices that can improve access for people who need mental health treatment. For instance, the Department of Labor released a new toolkit earlier this year that helps employers create supportive work cultures. Though digital solutions cannot always replace in-person mental health care, telepsychiatry and even mental health mobile apps show promise to increase access across the board. In addition, local-level collaborations between mental health care providers and the legal system are attempting to address the major nation-wide nexus between corrections and mental illness.
While America has improved access on some fronts, timely and appropriate mental health treatment still evades many who need help. Opening more doorways to access will bolster the health of individuals and their families, with positive repercussions outward into workplaces and communities.
If you or someone you know is suffering from a mental health crisis, you can reach the National Suicide Prevention Lifeline at 1-800-273-8255.
To find resources on obtaining treatment near you, NAMI offers a list of helpline resources here.
Learn more about what APM | MPR is doing in the mental health space at www.calltomindnow.org.