The State of Mental Health in America 2022: Adult Prevalence and Access to Care

Part One in a Series 

More than a year and a half into the COVID-19 pandemic, it’s no surprise that Americans continue to struggle with their mental and behavioral health. Within our families and communities, there have been irreparable changes that continue to affect us, even as more workplaces and businesses opened and schools resumed in-person classes.

One organization that has continually sought to examine our nation’s collective mental well-being is Mental Health America, a community-based non-profit organization dedicated to promoting mental health as a critical component of our overall wellness.

For the 8th year in a row, Mental Health America (MHA) has undertaken a collection and analysis of data concerning mental health in all 50 states and the District of Columbia. The resulting information is compiled into The State of Mental Health in America 2022 Report.

This impressive undertaking helps to offer us a baseline understanding of how many people in America need or have access to mental health care, and gives us information on the prevalence of various mental health concerns, including anxiety, depression, and suicidal ideation. 

An Important Note about COVID-19 and the Survey Data

It’s important to note that despite being labeled as the 2022 survey, respondent data was collected primarily in 2019. This means that comprehensive data reflective of our mental health needs during the COVID-19 pandemic will not be released until next year. The report writers note that as a result, the current mental health prevalence displayed in this year’s report is likely being under-reported.

The report offers a wealth of information and looks at two distinct subsets of the general American population–children and adults–so the synopsis of the report will be broken into two parts. The focus of this particular article will look at the mental health challenges in the adult population. A separate blog will focus exclusively on the mental health challenges of children and adolescents. Let’s take a deeper look into this year’s findings as they relate to adults.   

Key Takeaways

  • 19.85% of American adults experienced a mental health concern in 2019. That’s more than 50 million people.
  • 24.7% of Americans with these mental health concerns are not receiving the care they need – a number that has not declined since 2011.
  • More than 50% of adults with mental health concerns are receiving no treatment whatsoever.
  • Almost 5% of adults report experiencing suicidal ideation. This number has been steadily increasing for the last 10 years.
  • 11.1% of Americans with a mental illness are uninsured. This indicator has been rising since last year, which was the first year it increased since the passage of the Affordable Care Act.
  • This year, states with the lowest prevalence of mental illness include New Jersey, Florida, and Georgia. The highest instances of mental illness were tracked in Alaska, Vermont, and Oregon.  

Current Trends in Mental Health in America

Some Americans’ lives have changed significantly over the last year, while some have remained resolutely the same. Regardless of their circumstances, many Americans are struggling with mental and behavioral health challenges. 

19.85% of the adult population reported at least one mental health concern, a figure that is up 0.85% since last year’s report. That increase may seem minimal, but represents a growth of nearly 3 million more Americans with mental or behavioral health issues. 

The percentage of people experiencing severe mental illness has also risen, from 4.55% in the previous year to 4.91% this year. This figure is almost identical to the number of people reporting serious suicidal thoughts, which sits at 4.58% of the individuals surveyed. That’s an increase of 664,000 people.

To cope with these mental health concerns like anxiety and depression, many individuals have turned to substances like alcohol or drugs to help them cope. More than 7% of Americans report a substance use disorder, a figure that nationally represents more than 19 million individuals. 

Access to Care

To help us prioritize areas that need our attention, it is helpful to understand how many people with mental health concerns in the United States are not in the care of a clinician. Over half of the adult population with mental or behavioral health challenges in the US are not receiving any treatment whatsoever. That’s more than 27 million people. 

For many Americans, insurance is an indicator of whether they will seek out treatment for a mental health condition, but it is not the only factor in play. Even among Americans with health insurance, 54% of adults receive no mental health treatment.

Some of the primary barriers reported for those not receiving treatment include limited coverage, lack of clinician availability, and a gap between primary care systems and behavioral healthcare. When examining these figures, we can see how something as simple as effective scheduling through a behavioral health EHR can improve a person’s access to care.  

Variations by State

Our country offers a wealth of ecosystems, populations, and religious and cultural beliefs that influence how we handle our mental health needs. Every state and county has its own public health authority, and state law influences everything from public health ordinances to health insurance availability and pricing, and so much more. 

This year, there are some interesting figures that indicate the impact that state laws and regional customs have on mental and behavioral healthcare. For example, it’s easier to understand why places like Florida and West Virginia report a high prevalence of individuals with substance abuse issues when you learn that both states rank on the lower end of mental health workforce availability, with an average of 1 clinician to every 590 to 730 individuals.   

While these figures are helpful, correlation does not necessarily equal causation. For example, the states that report the lowest percentages of individuals with insurance (Alabama, Missouri, and Texas) are not necessarily the ones with the highest mental illness prevalence. 

Final Thoughts

When examining these figures, it’s important to remember that data only tells part of the story. However, it offers a good place to start when trying to determine how to improve mental health outcomes nationally.

From a clinical standpoint, knowing that the overall prevalence of mental health concerns is rising around the United States offers behavioral healthcare providers an opportunity to share this knowledge with clients so they feel less isolated. 

Being able to offer this reassurance provides a point of connection, which can be used to build trust with clients and provide an even more meaningful and effective treatment experience.


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