New survey: More than 4 in 10 US adults who needed substance use and mental health care didn’t get care

An alarming number of people cope with a substance use or mental health challenge.

The number of adults reporting symptoms of anxiety or depressive disorder nearly tripled during the pandemic, from 11.0 percent in 2019 to 31.6 percent in the fall of 2021, according to the Kaiser Family Foundation. The Centers for Disease Control and Prevention on May 11 reported that drug overdose deaths increased 15 percent in 2021 to nearly 108,000 deaths.

New data released today reveals another alarming fact: 43 percent of U.S. adults who say they needed substance use or mental health care in the past 12 months did not receive that care, according to a national survey of more than 2,000 U.S. adults conducted online by The Harris Poll on behalf of the National Council for Mental Wellbeing.

So, why aren’t we doing more to help people overcome substance use and mental health challenges? As we observe Mental Health Awareness Month throughout May, we must work harder to answer that question.

While 43 percent of U.S. adults who say they needed substance use or mental health care in the past 12 months did not receive that care, just 21 percent of those who needed primary care and did not receive it, according to data from the new report, 2022 Access to Care Survey.

There is no health without mental health, and we must eliminate barriers to access.

Majorities of U.S. adults who needed care cited difficulties getting it, including those who did receive care. The primary barriers to access for those with unmet needs for substance use or mental health challenges over the past 12 months include cost-related issues (no insurance, out-of-pocket costs, 31 percent and 37 percent, respectively), the inability to find a conveniently located provider (22 percent and 28 percent, respectively) and the inability to get an appointment immediately when they needed care (31 percent and 25 percent, respectively).

Those who did receive substance use or mental health care over the past 12 months also cited difficulties in getting that care: 

• 81 percent of U.S. adults who received substance use care had trouble getting care. 
• 67 percent of U.S. adults who received mental health care experienced difficulties getting care. 

The survey also found that nearly 3 in 5 U.S. adults believe it is easier (59 percent) and faster (59 percent) to get substance use or mental health care if you pay out-of-pocket versus using insurance.In addition, 71 percent of U.S. adults would be more likely to get substance use or mental health care if they could receive it through their primary care doctor, if they needed it, and 67 percent think it’s harder to find a mental health care provider than it is to find a physical health care provider. 

So, what can we do? Our will to correct these problems and help people find the care they need and deserve must be stronger than the challenges we face. We cannot be mentally well and actively thriving if we are unable to access services.

The industry has difficulty fulfilling the need for treatment in communities across the country due to a shortage of mental health and substance use professionals. Communities need more substance use and mental health professionals. The lack of psychiatrists, nurse practitioners, social workers, case managers and more limits the ability to provide care.

Passing the bipartisan Mental Health Access Improvement Act (S. 828/H.R. 432) would allow marriage and family therapists and mental health counselors receive reimbursement from Medicare for their services. Passing the Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act (S. 2144/H.R. 2767) would allow peer support specialists to participate in providing integrated mental health services, the care coordinated by both primary and behavioral health clinicians, to Medicare beneficiaries.

We can also permanently lift restrictions on telehealth. During the pandemic, many organizations quickly transitioned from in-person services to telehealth and technology-assisted services, and this increased use of technology is expected to continue.

We can continue to invest in Certified Community Behavioral Health Clinics (CCBHCs) by passing the Excellence Act (S. 2069/H.R. 4323). CCBHCs provide a full array of services and supports, integrated with primary care and coordinated with other social service providers, reduce wait times, expand states’ capacity to address the overdose crisis and establish innovative partnerships with law enforcement, schools and hospitals to improve care, reduce recidivism and prevent hospital readmissions. 

Finally, stigma represents a significant barrier. We must overcome the fear and discrimination that so often prevent people from seeking treatment. Acknowledging the need for treatment provides hope that mental wellbeing — thriving regardless of a mental health or substance use challenge — is within reach.

The opportunity to be healthy and achieve wellbeing eludes many people. But we have so many opportunities to improve care for those with substance use and mental health challenges. As we observe Mental Health Awareness Month, let’s take advantage of those opportunities. 

Our mental wellbeing depends on it. 

Chuck Ingoglia is president and CEO of the National Council for Mental Wellbeing.