State of Mental Health in America 2020 Report

From the MHA Website: Mental Health America is committed to promoting mental health as a critical part of overall wellness. We advocate for prevention services for all, early identification and intervention for those at risk, integrated services, care and treatment for those who need it, and recovery as the goal. Click here to download full report.


Report Key Findings:

  • Youth mental health is worsening. From 2012 to 2017, the prevalence of past-year Major Depressive Episode (MDE) increased from 8.66 percent to 13.01 percent of youth ages 12-17. Now over two million youth have MDE with severe impairment.

  • Adult prevalence of mental health is relatively stagnant, but suicidal ideation is increasing. Suicidal ideation among adults increased from 3.77 percent in 2012 to 4.19 percent in 2017. That’s over 10.3 million adults in the U.S. with serious thoughts of suicide.

  • Prevalence of substance use disorder (SUD) decreased in both youth and adults. The prevalence rate of substance use disorder, including illicit drug or alcohol dependence or abuse, in adults in the past year decreased from 8.46 percent in 2012 to 7.68 percent in 2017. The prevalence rate of substance use disorder in youth ages 12-17 decreased to 4.13 percent in 2017.

  • More Americans are insured, but their coverage is lacking. The proportion of youth with private insurance that did not cover mental or emotional difficulties nearly doubled, from 4.6 percent in 2012 to 8.1 percent in 2017.

  • There is still unmet need for mental health treatment among youth and adults. Only 28.2 percent of youth with severe MDE were receiving some consistent treatment, and over 10 million adults still report an unmet need for mental health care.

  • Youth are not being identified as having an Emotional Disturbance, which can keep them from accessing necessary accommodations. The proportion of students identified with an Emotional Disturbance for an Individualized Education Program (IEP) was only 7.33 percent per 1,000 students in 2017.


Access to Care Data


Youth Data


Adult Data

  • 18.57% of adults are experiencing a mental health illness, equivalent to 45 million Americans.

  • 4.38% are experiencing a severe mental health illness.

  • The state prevalence of adult mental illness ranges from 16.19% in New Jersey to 25.03% in Idaho.

  • 7.68% of adults in America reported having a substance use disorder in the past year;

  • 2.72% an illicit drug use disorder in the past year;

  • 5.82% an alcohol use disorder in the past year.

  • The state prevalence of adults with substance use disorder in the past year ranges from 6.32% in Georgia to 11.55% in the District of Columbia.

  • The percentage of adults reporting serious thoughts of suicide is 4.19%.

  • The estimated number of adults with serious suicidal thoughts is over 10.3 million—an increase of nearly 450,000 people from last year’s data set.

  • The state prevalence of adults with serious thoughts of suicide range from New Jersey at 3.41% to Utah at 5.99%.

  • 10.3% (over 4.7 million) of adults with a mental illness remain uninsured.

  • Under the Affordable Care Act (ACA), the U.S. continues to see a decline in Americans who are uninsured. There was a 1.9 percent reduction from last year’s data set.

  • 57.2% of adults with a mental illness received no treatment.

  • Over 26 million individuals experiencing a mental health illness are going untreated.

  • The state prevalence of untreated adults with mental illness ranges from 40.7% in Vermont to 64.8% in California

  • Almost a quarter (22.3%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. This number has not declined since 2011.

  • Individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment:

  1. No insurance or limited coverage of services

  2. Shortfall in psychiatrists, and an overall undersized mental health workforce.

  3. Lack of available treatment types (inpatient treatment, individual therapy, and intensive community services).

  4. Disconnect between primary care systems and behavioral health systems.

  5. Insufficient finances to cover costs – including, copays, uncovered treatment types, or when providers do not take insurance.

  • The state prevalence of adults with AMI reporting unmet treatment needs ranges from 14.3% in Alabama to 31.2% in Utah.

  • The prevalence of adults with disability who couldn’t see a MD due to cost ranges from 16.87% in Iowa to 41.03% in Texas.


Additional Information and Sources

Behavioral Health Workforce Faces Critical Challenges in Meeting Population Needs (2018)

Building the Mental Health Workforce Capacity Needed To Treat Adults with Serious Mental Illnesses (June 2016)

Career Outlook: Careers in Social Work—Bureau of Labor Statistics (March 2018)

Mapping US Supply of Psychiatric Workforce, October 2018