In 2019, just prior to the COVID-19 pandemic, 19.86% of adults experienced a mental illness, equivalent to nearly 50 million Americans.  

Suicidal ideation continues to increase among adults in the U.S. 4.58% of adults report having serious thoughts of suicide, an increase of 664,000 people from last year’s dataset. The national rate of suicidal ideation among adults has increased every year since 2011-2012. This was a larger increase than seen in last year’s report and is a concerning trend to see going into the COVID-19 pandemic.

A growing percentage of youth in the U.S. live with major depression. 15.08% of youth experienced a major depressive episode in the past year, a 1.24% increase from last year’s dataset. In the bottom-ranked states, up to 19% of youth ages 12-17 experienced major depression.

​Rates of substance use are increasing for youth and adults, even prior to the COVID-19 pandemic. 7.74% of U.S. adults and 4.08% of youth had a substance use disorder in the past year. Substance use increased 0.07% for adults and 0.25% for youth over last year’s report.

Over 2.5 million youth in the U.S. have severe depression, and multiracial youth are at greatest risk. 10.6% of youth in the U.S. have severe major depression (depression that severely affects functioning). The rate of severe depression was highest among youth who identified as more than one race, at 14.5% (more than one in every seven multiracial youth).

Over half of adults with a mental illness do not receive treatment, totaling over 27 million adults in the U.S. who are going untreated. In Hawaii, the bottom-ranked state, 67% of adults with a mental illness did not receive treatment. Even in Vermont, the top-ranked state in the U.S., 43% of adults experiencing a mental illness were not receiving treatment. 

The percentage of adults with a mental illness who report unmet need for treatment has increased every year since 2011. In 2019, 24.7% of adults with a mental illness report an unmet need for treatment. 

Over 60% of youth with major depression do not receive any mental health treatment. Even in states with the greatest access, nearly one in three are going without treatment. In Texas, the bottom-ranked state for this indicator, nearly three-quarters of youth with depression did not receive mental health treatment. 

Nationally, fewer than 1 in 3 youth with severe depression receive consistent mental health care. Even among youth with severe depression who receive some treatment, only 27% received consistent care. In Tennessee, the bottom-ranked state, that rate is as low as 12%. 65.6% of youth in Maine (ranked 1st) received consistent treatment, which is 16% higher than Vermont (49.7%) which is ranked 2nd.

Both adults and youth in the U.S. continue to lack adequate insurance coverage. 11.1% of Americans with a mental illness are uninsured. There was a 0.3% increase from last year’s dataset, the second year in a row that this indicator increased since the passage of the Affordable Care Act (ACA). 8.1% of children had private insurance that did not cover mental health services, totaling 950,000 youth.