Older Adults and Mental Health: What Are the Latest Facts?

Summary: Among older adults – age 60 and up – the prevalence of clinical mental health disorders and suicidality are below the national average for all adults over age 18. However, rates of treatment for adults over age 60 are also below the national average for adults over age 18.

Insight:

Members of the generation that gave us the mental health professionals and scientists who revolutionized mental health treatment – Baby Boomers – seek treatment less frequently than members of Gen X, the Millennial Generation, and Gen Z.

Older Adults, Mental Health, and Mental Health Treatment

Discussion around mental health in popular culture, meaning the talk we see in the news and on social media, mostly addresses mental health challenges and crises among youth, adolescents, and young adults. Conversations cover people of ages that correspond with the Gen Z and Millennial generations but often stop when we approach older Gen Xers.

In this article, we’ll give the older adults in the U.S. the attention they both need and deserve, thanks to a new publication from the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) called “Behavioral Health Among Older Adults: Results from the 2021 and 2022 National Surveys on Drug Use and Health (NSDUH),” published earlier this year, as the treatment community patiently awaits the release of the 2024 NSDUH.

We’ll share data on the prevalence of mental illness, major depressive episode, and suicidality among adults over age 60, as well as rate of suicidality and suicide fatalities. Then we’ll compare prevalence rates for adults over age 60 with prevalence rates for all adults over age 18 in order to give context and perspective to the current state of mental health among older adults in the U.S.

We’ll start by defining the terms you’ll see in the statistics, then share the latest facts and figures on mental health among older adults.

The NSDUH Special Report on Older Adults and Mental Health

This special report pools data from the 2021 and 2022 NSDUH publications. These annual, nationwide surveys collect data on mental health, behavioral health, addiction and related topics from over 70,000 participants. Researchers typically report prevalence rates in the following age groups:

• 12-17
• 18-25
• 26-49
• 50-64
• 65+

For this publication, they created a new age group – adults over age 60 – to give insight into the current state of mental health among older adults. Here are the categories the report covered, with definitions.

1. Any mental illness (AMI): Presence of a mental, behavioral, or emotional disorder in the past year of sufficient duration to meet criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, excluding developmental disorders and substance use disorders.
2. Serious mental illness (SMI): Presence of a mental, behavioral, or emotional disorder that substantially interfered with or limited one or more major life activities.
3. Major depressive episode (MDE): In the past 12 months, presence of (1) feeling depresses or experiencing loss of interest or pleasure in daily activities for most of the day, every day, for two weeks or more one period of 2 weeks or more, and (2) problems with sleeping, eating, energy, concentration, self-worth, or recurring thoughts of death and/or recurring suicidal ideation.
4. Mental health treatment: Receipt of treatment or counseling for any problem with mental health, emotions, or behavior in the past 12 months. Treatment may occur at an inpatient location, outpatient location, via telehealth, or a carceral setting, and may or may not include prescription medication.
5. Suicidality: Thinking about suicide, planning suicide, or attempting suicide in the past 12 months. To add depth to this data, we’ll share data on suicide fatalities among older adults from this CDC resource.

With those terms defined, let’s get straight to the data.

Prevalence of Mental Health Disorders Among Older Adults

We’ll start with AMI and SMI, as defined above.

Mental Illness Among Adults Over Age 60

Any Mental Illness:

• Total: 12.5% (9.8 million)
  • Female: 14.8% (6.2 million)
  • Male: 9.8% (3.6 million)

National Average, 18+: 23.1%

Serious Mental Illness:

• Total: 1.9% (1.5 million)
  • Female: 2.6% (1.1 million)
  • Male: 1.1% (0.4 million)

National Average, 18+: 6.0%

Older adults reported AMI at roughly half the rate of all adults, and SMI at roughly one-third the rate of all adults. Older females reported AMI about 50 percent more than older males, and SMI about at about twice the rate of males.

Next, the data on MDE, as defined above.

Major Depressive Episode (MDE)

• Total: 3.5% (2.7 million)
  • Female: 4.5% (1.9 million)
  • Male: 2.4% (0.9 million)

National Average, 18+: 8.8%

Older adults reported MDE at less than half the rate of all adults, with older females reporting MDE at about half the rate as males.

Now we’ll shift the focus from rates of mental illness to rates of treatment for mental illness.

Treatment for Mental Illness Among Adults Over Age 60

All Adults Over 60:

• 0% (12.7 million)
  • Female: 19.6% (8.3 million)
  • Male: 11.9% (4.4 million)

National Average, 18+: 21.8%

Among all adults over 60, including those without mental illness, females received treatment at almost twice the rate of males.

Adults Over 60 With AMI:

• 3% (12.7 million)
  • Female: 51.9% (8.3 million)
  • Male: 37.2% (4.4 million)

National Average, With AMI, 18+: 50.6%

Among all adults over 60 with mental illness, the difference between females and males decreased, with females receiving treatment about a third more frequently than males.

We’ll discuss these results below, after we shift focus again, and report the latest figures on suicidality and suicide fatalities.

Suicidal Behavior: Thinking About, Planning, Attempting Suicide

In this section, the titles explain the measure. Having serious thoughts of suicide and planning suicide fall a broader category called suicidal ideation. When we add suicide attempts, that category becomes suicidality. Finally, the last set of data – suicide fatalities – needs no explanation.

Suicidality Among Adults Over Age 60

Serious Thoughts of Suicide

• Total: 1.7% (1.3 million)
  • Female: 1.6% (609,000)
  • Male: 1.7% (682,000)

National Average, 18+: 5.2%

Older adults reported serious thoughts of suicide at about a third the rate of all adults, with males and females reporting similar rates.

Made Suicide Plan

• Total: 0.3% (265,000)
  • Female: 0.3% (129,000)
  • Male: 0.4% (136,000)

National Average, 18+: 1.5%

Older adults reported serious thoughts of suicide at about one fifth the rate of all adults, with males and females reporting again reporting similar rates.

Attempted Suicide

• Total: 0.2% (179,000)
  • Female: 0.2% (93,000)
  • Male: 0.2% (85,000)

National Average, 18+: 0.6%

Older adults reported attempted suicide at about a third the rate of all adults, with males and females reporting similar rates, repeating the trend established by the previous two suicidality metrics.

Now, the last set of figures: suicide fatalities. The NSDUH report did not include this information, which is publicly available in the CDC report “Suicide Mortality in the United States, 2002–2022.” This data isn’t a perfect match with the age categories we report on in the rest of this article, but the 65-74 age category can help give us a general idea about rates of suicide fatality among older adults.

Died By Suicide, Adults 65-74

• Total: 17.3 per 100,000
  • Female: 5.8 per 100,000 (1,040)
  • Male: 28.7 per 100,000 (8,460)

National Average, 18+, 2021-2022: 9.65 per 100,000

In 2021-2022, males died by suicide at a rate five times greater than females.

We’ll address that significant disparity between male and female suicide fatalities below, along with our discussion of all the data above.

How Does This Information Help?

This information gives us concrete facts about how older adults in the U.S. are doing, mental-health wise. When we consider the data on any mental illness and serious mental illness, for instance, we see rates far below those reported for all adults over age 18. This pattern persists for major depressive episode (MDE) as well.

What’s going on there?

Is it because older adults are more reluctant to disclose their mental health status in a survey?

That’s possible, yet when we look at rates of treatment for all adults, including those without mental illness, the differences begin to shrink. And when we look at treatment rates among people with mental illness, the differences shrink much further, separated by only a few percentage points.

What does that mean?

We suggest it may mean that while older adults may not want to talk about their mental health in general, they’re willing to engage in treatment for mental health. That does make senses, especially in light of the insight we offer in the introduction to this article – scroll back up and look, if you forgot about it.

That leaves us with three things to address, in the form of three questions:

1. How do we handle the treatment gap, or the difference between the number of people who need treatment and the number of people who get it? In the data above, we see that less than half of people over age 60 with mental illness get treatment. When we mention treatment above, we refer to relative rates between age groups, not overall treatment rates. For the record, a treatment gap of 50 percent – with the resources available in 2025 – is completely unacceptable. For an in-depth look at this topic, please read this article:

How Can We Close the Mental Health Treatment Gap?

2. How can we explain the extreme difference between suicide fatalities among males and females, when rates of suicide attempts were similar? The answer to this is, unfortunately, made clear later in the CDC report on suicide between 2002 and 2022. Among the means of suicide reported – firearm, poison, suffocation, other – males used firearms 11 times more often than females, and suffocation about three times more often: 13.5 per 100,000 compared to 2.0 per 100,000 for firearms, and 5.8 per 100,000 compared to 1.6 per 100,000 for suffocation.

That’s the answer: men attempted suicide with means more consistently lethal than women.

3. Do women really have mental illness at two to three times the rate of men – or are they simply more willing to talk about it?

This is an open question, for which we have – and the research has, to date – no satisfactory, evidence-based answer.

We’ll end here, with that question on our minds, but with a significant amount of data that answers important questions about mental health among older adults in the U.S. In short, adults over 60 appear to be doing okay, mental health-wise, compared to all adults over age 18.

But we need to close that treatment gap: if you’re an older adult with mental health problems, you’re not alone: please seek support. And if an older friend or loved one needs support, please talk to them, and encourage them to seek professional support sooner rather than later.