How Can We Close the Mental Health Treatment Gap?

Summary: We can close the mental health treatment gap by reducing stigma around mental health, spreading awareness about mental health disorders and mental health treatment, and by teaching people that with evidence-based support, individuals with mental health challenges can heal, grow, and lead productive and rewarding lives.

What is the Mental Health Treatment Gap?

Mental health experts and researchers define the treatment gap as follows:

“…the percentage of individuals who require treatment in a country or a defined community but do not receive it due to various reasons. There is widespread acceptance of treatment gap as a measure of unmet needs in mental health.”

It’s important to understand that mental health treatment involves more than the modes of treatment people recognize as typical, such as medication and various forms of psychotherapy.  Comprehensive mental health treatment also includes physical treatment for comorbidities, psychosocial support for environmental and lifestyle factors, and lifestyle changes to improve overall quality of life.

However, for the purposes of our discussion, we’ll narrow the focus to three of specific types of support, which are among the most commonly utilized today:

• Outpatient psychotherapy, with or without medication
• Prescription medication, with or without psychotherapy
• Psychotherapy via telehealth, with or without medication

First, let’s review why it’s important to get treatment for mental health issues, whether they’re mild, moderate, or severe.

Consequences of Untreated Mental Health Problems

• Small issues can escalate and become serious and disruptive
• Disruptive symptoms can impair:
  • Self-esteem, confidence
  • Full participation in typical daily activities
  • Relationships: family, peer, romantic/intimate
  • Academic achievement
  • Work: the ability to find and maintain gainful employment
  • Physical health
• Risk of suicidality: thinking, planning, or attempting suicide

We mention suicidality not for shock value, but to put the stakes related to the treatment gap in perspective. While mild mental health issues may cause discomfort, and in some cases, resolve relatively quickly with treatment, it’s imperative to understand that serious mental health issues can escalate, and increase risk of suicidal behavior.

How Many People Need Mental Health Treatment? The Latest Facts and Figures

To understand how many people need treatment but don’t get it, we need to establish how many people need treatment. The following data appears in the 2023 National Survey on Drug Use and Health, a large-scale, annual report that includes information on over 70,000 people from around the U.S. The NSDUH helps us identify both current rates and long-term trends in mental and behavioral health.

We’ll start with the latest rates on mental illness. The following bullet points show current rates of any clinical mental health diagnoses among adults over age 18.

Adults With Any Mental Illness (AMI) in 2023:

• By Age Group:
  • Total, 18+: 22.8%
  • Young Adults 18-25: 33.8%
  • Adults 26-49: 29.2%

That’s over 58 million people with a mental illness, in need of treatment. We’ll share treatment rats, below. Firsts let’s look at current rates of diagnoses of serious mental illness among adults over age 18.

Adults With Serious Mental Illness (SMI) in 2023:

• By Age Group:
  • Total 18+: 5.7%
  • Young adults 18-25: 10.5%
  • Adults 26-49: 7.9%

That’s over 14 million people with a serious mental illness, in need of treatment. Reminder: serious mental illness can have serious consequences, which we point out above. Next, we’ll look at how many of these people who needed treatment received treatment.

Identifying the Treatment Gap: How Many People Didn’t Get the Treatment They Needed?

These datasets are also from the 2023 NSDUH, which surveys rates of mental health treatment as well as overall prevalence of mental health disorders. We’ll start with the big picture data, which tells us, among all adults in the U.S., how many got treatment. We’ll limit the detailed information to the type of treatment we offer – outpatient treatment – and include rates of prescription medication and telehealth as well, to provide context.

Mental Health Treatment, Any Disorder, All Adults

18+ total: 23%

• Outpatient: 14.1%
• Took prescription medication: 16.3%
• Telehealth: 12.1%

That’s just over 59 million adults who reported receiving any kind of mental health treatment for any type of disorder, with or without a clinical diagnosis, 36 million receiving outpatient treatment, and 31 million receiving treatment via telehealth.

Next, we’ll share rates of treatment among people with a clinical diagnosis for any mental illness of any level of severity.

Mental Health Treatment, Any Mental Illness

Total 18+: 53.9%

• Outpatient: 37.6%
• Took prescription medication: 40.4%
• Telehealth: 33.7%

That’s 31.6 million people who received any kind of treatment, 11.7 million receiving outpatient treatment, 12.6 million receiving prescription medication, and 10.6 million receiving treatment via telehealth.

Next, rates of treatment among people with any clinical diagnosis for a severe mental illness.

Mental Health Treatment, Serious Mental Illness

Total 18+: 71.1%

• Outpatient: 55%
• Took prescription medication: 59.8%
• Telehealth: 49.4%

That’s 10.4 million people who received any kind of treatment, 5.7 million people receiving outpatient treatment, 6.1 million receiving prescription medication, and 5.1 million receiving treatment via telehealth.

We’ll discuss this data below.

How We Can Close the Treatment Gap, And a Question

We’ll start with the question:

Why do we delay getting treatment?

When we look over the data above, we’re encouraged by the fact that 71 percent of people with serious mental illness get the treatment they need. That’s still far short of optimal – 100 percent – but it’s far greater than the 53.9 percent of people with any mental illness. That’s a serious discrepancy.

We think we know the cause:

We put things off until we can’t ignore them anymore.

These differences also appear in the number of people with a major depressive episode – a proxy metric for diagnosis of major depressive disorder (MDD) – who got the treatment they need:

• MDE without severe impairment, received treatment: 66.7%
• MDE with severe impairment, received treatment: 70.1%

Those differences aren’t quite as dramatic, but they demonstrate our point. It appears we default to ignoring mental health issues until they cause significant problems. Keep in mind that major depressive episode is just that: major. And we see rates of treatment for MDE far greater than rates of treatment for people with any mental illness (AMI).

Let’s be clear: we think waiting to seek treatment until a mental health issue causes severe problems/significant life disruption is a mistake. Millions of people every year receive professional, evidence-based support for mental health concerns. Effective treatment is available. The treatment gap is closable.

Here’s how we can do it.

Closing the Treatment Gap: Three Simple Steps

1. Reduce Stigma. When we normalize conversations around mental health and mental health treatment, we reduce the shame, fear, and hesitation about menta health disorders and seeking treatment for mental health disorders. When people know they’ll be accepted and not judged, the gap will begin to close. When people know they’ll be welcomed with open arms – and not merely tolerated – then they’ll be more likely to seek treatment, and the gap will begin to close.
2. Increase Awareness. The more people know about mental health – for instance, the fact that almost 60 million people, roughly 1 in every 5 adults in the U.S. receive some form of mental health treatment each year – the more likely they will be to seek treatment, and the gap will begin to close.
3. Educate Friends and Peers. Evidence-based treatment delivered by qualified professional providers can help people with mental health issues reduce symptoms, regain balance, and in most cases, return to full participation in the typical daily activities, including work, school, soia life and family life.

That last point is crucial: many people are skeptical about whether treatment works. We’re here to confirm that treatment can and does work – and the sooner a person who needs mental health treatment gets the treatment they need, the better the outcome.