1 in 5 Americans Sought Mental Health Help During the Pandemic

Since the pandemic began in 2020, mental health issues have sky rocketed. But there is one silver lining: New reports show people may be seeking more mental health care.

The National Health Interview Survey (NHIS) data seem to confirm it. The survey found that the percentage of adults who had received any mental treatment in the past 12 months “significantly increased from 19.2% in 2019 to 20.3% in 2020,” Emily Terlizzi, MPH, a researcher with the National Center for Health Statistics (NCHS), tells Verywell via email. The results were published in October.

Because the NHIS does not examine the reasons for use, Terlizzi says, it’s difficult to conclude exactly why more people accessed mental health care.

Still, Dawn Morales, PhD, program chief of rural mental health research at the National Institute of Mental Health (NIMH), tells Verywell that the data may reflect an increased willingness to seek help when faced with the stressors associated with 2020. “[This] could be a good sign,” she says.

“The National Health Interview Survey is the principal source of information on the health of the civilian population of the United States,” Morales adds. “Many of the findings are similar to other years, such as the finding that more women sought care than men. But there are some changes as well.”

And they’re worth looking into.

U.S. Trends in Mental Health Care

The slight uptick in mental health treatment could signal a growing trend, but it’s hard to know if it will continue past 2020. Regarding the other trends found, they don’t differ much from 2019. But they do offer more detail on who is seeking treatment and where.

Of that 20.3% of people who received any mental health treatment in the past 12 months, 16.5% had taken prescription medication and 10.1% had received counseling or therapy for their mental health. In general, older individuals were more likely to take medication, and younger individuals were more likely to receive counseling or therapy.

Non-Hispanic White adults were most likely to have received any mental health treatment (24.4%), followed by:

• Non-Hispanic Black people (15.3%)
• Hispanic people (12.6%)
• Non-Hispanic Asian people (7.7%)

Although the reasons for these differences were not discussed in the report, past research has linked lower rates of mental health treatment among marginalized groups to systemic racism, increased difficulty accessing health insurance, and long-entrenched financial barriers.

A 2018 study concluded that “racial/ethnic minorities in the United States are more likely than Whites to have severe and persistent mental disorders and less likely to access mental health care.”

Women were also more likely than men to have received any mental health care. Terlizzi and colleagues say this was consistent with existing research. Past studies have found that anxiety and depression are both more prevalent among women and that women appear more willing to seek out mental health care.

However, these findings don’t account for all gender-based trends. For instance, while anxiety and depression are more commonly diagnosed in women, other disorders like antisocial personality disorder and substance use disorder are more often diagnosed in men. At the same time, gender biases can play into how people are diagnosed.

Finally, Terlizzi and colleagues found that people living in urbanized areas were more likely to receive mental health treatment through counseling or therapy. The less urbanized the area, the more likely the people there were to obtain mental health care through medication.

The Rural and Urban Divide

The NHIS found various trends that have been identified before. However, one trend—the difference in the type of mental health care sought out between urbanized and less urbanized environments—is not as well-studied.

The finding that rural residents are more likely to take medications and urban residents are more likely to seek therapy, “is quite interesting and does not completely surprise me,” Morales says.

While we don’t yet have evidence to explain this trend, Morales guesses that it may have to do with access. For example, people in less urbanized environments, she says, may depend more on their primary care providers (PCP), who more commonly prescribe medications themselves because they have a more limited pool in which to make referrals.

“There is greater availability of therapy in metropolitan areas and PCPs in these areas may have more referral options on average,” she says.

Although telehealth treatment has expanded since the pandemic, she adds, “rural areas that lack broadband access may not have benefited from that innovation in the same way that other areas have.”

In 2018, the Federal Communications Commission (FCC) estimated that about a quarter of rural Americans, and a third of Americans living on tribal lands, did not have access to broadband. These findings have led tech leaders to advocate for making broadband a “fundamental right.”

The Future of Mental Health Care

Differences in access to mental health treatment between urbanized and less urbanized environments could reduce in a post-pandemic world.

“The increase in access to telemental health does pose some exciting possibilities for rural residents,” Morales says.

In addition to expanding telehealth services during the early stages of the pandemic, many states also allowed providers more flexibility in who they worked with. That is, previous licensure limitations, which stipulated that professionals could only offer services in their state, were waived in many states.

Suddenly, telehealth allowed you to access health professionals in different states. Now, some wonder if permanently unlimiting telehealth by borders would expand access overall.

“A shift away from a geographic emphasis on licensure and restrictive networks also could facilitate more telehealth,” professors of policy and medicine from Harvard University and Dartmouth College wrote in May 2020.

Expanded mental health care through telehealth could help people access providers who specialize in what they’re looking for and need. For example, individuals with racial, ethnic, sexual, or gender identities who have historically been marginalized, Morales says, “may find it easier to get culturally competent care with greater access to telemental health services.”

And if someone’s diagnosis requires attention from a professional with specialized training, people may more easily find them without having to go too far.

Although Morales would like to see more widespread incorporation of mental and behavioral health care within primary care clinics in rural areas, that’s largely dependent on financial support to start until they become self-supporting.

“This process can take years,” she says. “But the evidence suggests a strong return on investment.”

That is, studies have found that health care systems that are more integrated are cost-effective and can lead to significant savings in healthcare costs long-term.