Mental health treatment disparities at a glance
Whether an American with a mental illness receives treatment depends heavily on race, sex, income and insurance. According to the 2024 National Survey on Drug Use and Health, 57.9 percent of White adults with any mental illness received mental health treatment, compared with 44.1 percent of Hispanic adults, 38.5 percent of Black adults and 32.5 percent of Asian adults. Women with a mental illness were treated in 59.2 percent of cases, men in only 42.1 percent.
Income and insurance matter too. In 2024, 55.5 percent of adults with a mental illness living at twice the federal poverty level or more received treatment, compared with 45.8 to 48.8 percent of those on lower incomes. Among adults who had seriously thought about suicide, 53.8 percent of insured adults received treatment, but only 26.1 percent of the uninsured. These gaps have persisted for years and appear in every major federal survey.
This report looks at differences by race and ethnicity, sex, income, education, insurance and place of residence, using SAMHSA and CDC data. The national context is set out in our hub on mental health treatment in the US. Overall treatment levels are covered in our report on adults receiving mental health treatment, and the total number of untreated adults in our report on untreated mental illness.
- Most figures show the share of adults with any mental illness (AMI) who received treatment, so they compare access to care among people who need it.
- Estimates for American Indian or Alaska Native and Native Hawaiian or Pacific Islander adults are often suppressed by SAMHSA because samples are small.
- Data from different survey years and methods are shown separately and should not be joined into one trend.
Large racial and ethnic gaps
The racial gap in treatment is one of the most persistent findings in US mental health data. In pooled data for 2022 and 2023, 57.4 percent of White adults with a mental illness received treatment, compared with 56.1 percent of multiracial adults, 43.5 percent of Hispanic adults, 40.9 percent of Black adults, 38.8 percent of American Indian or Alaska Native adults and 35.4 percent of Asian adults. In absolute numbers, 22.0 million White adults with a mental illness were treated, compared with 4.1 million Hispanic and 2.5 million Black adults.
Asian adults least likely to be treated: About one in three Asian adults with a mental illness received care.
The 2024 survey confirms the pattern. After adjusting for other factors, SAMHSA found that Hispanic adults with a mental illness had 0.62 times the odds of receiving treatment of White adults, Black adults 0.47 times and Asian adults 0.31 times. Native Hawaiian or Pacific Islander adults had just 0.16 times the odds.
| Group | Treated, adults with AMI 2024 | Adjusted odds vs White adults |
|---|---|---|
| White | 57.9% | 1.00 (reference) |
| Two or more races | 52.0% | n/a |
| Hispanic | 44.1% | 0.62 |
| Black | 38.5% | 0.47 |
| Asian | 32.5% | 0.31 |
| Native Hawaiian or Pacific Islander | suppressed | 0.16 |
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Earlier data show that the gaps are even larger when looking at all adults rather than only those with a mental illness. In the years 2015 to 2019, 18.3 percent of all White adults received mental health services each year on average, compared with 8.9 percent of Black adults, 8.7 percent of Hispanic adults and 5.9 percent of Asian adults. Black adults were, however, the group most likely to receive inpatient care, at 1.5 percent.
Three times the rate: White adults used mental health services three times as often as Asian adults.
A gender gap in care
Men with a mental illness are much less likely to be treated than women. In 2024, 42.1 percent of men with any mental illness received treatment, compared with 59.2 percent of women, and SAMHSA estimated that men had about half the odds of receiving treatment, 0.51. The gap is visible within every racial and ethnic group: in 2015 to 2019, 12.5 percent of White men received mental health services compared with 23.9 percent of White women, and 7.3 percent of Black men compared with 10.2 percent of Black women. Population figures by sex are in our report on the population of the US by sex and age.
Women in every group: Women of every race and ethnicity used mental health services more often than men.
Income, education and insurance
Treatment rises with income, but not in a straight line. In 2024, 48.8 percent of adults with a mental illness living below the poverty line received treatment, 45.8 percent of those between 100 and 199 percent of the poverty line, and 55.5 percent of those at 200 percent or more. People with the lowest incomes may be helped by Medicaid, which most mental health facilities accept, while the near poor often fall into a gap between public and private coverage.
The near poor fall behind: Adults just above the poverty line were least likely to be treated.
Education and insurance make an even bigger difference for people in crisis. Among the 14.3 million adults who had serious thoughts of suicide in 2024, 50.3 percent received mental health treatment. The share was 57.0 percent among college graduates but only 34.0 percent among adults without a high school diploma. Insured adults were treated twice as often as the uninsured, 53.8 compared with 26.1 percent. Facilities that offer free or low-cost care are covered in our report on mental health treatment facilities.
Education matters: College graduates in crisis were treated far more often than those without a diploma.
What the National Health Interview Survey shows
The CDC National Health Interview Survey shows the same racial pattern. In 2020, 24.4 percent of White adults received mental health treatment, compared with 15.3 percent of Black adults, 12.6 percent of Hispanic adults and 7.7 percent of Asian adults. Asian adults were especially unlikely to receive counseling: 4.8 percent compared with 11.2 percent of White adults.
Same pattern, different survey: White adults were treated three times as often as Asian adults.
Among younger adults aged 18 to 44, the CDC reported higher treatment in 2021 than in 2019 for White adults, 30.4 compared with 23.8 percent, and Asian adults, 10.8 compared with 6.0 percent. Among Black adults the share was 12.4 percent in 2019, 17.0 percent in 2020 and 14.8 percent in 2021. Place of residence also plays a role: in 2024, 22.9 percent of adults in nonmetropolitan areas took mental health medication compared with 16.7 percent in large central cities, but only 10.6 percent received counseling, compared with 15.2 percent. The shortage of providers in rural areas is described in our report on the mental health workforce.
Pills in the country, therapy in the city: Rural adults take more medication but get less counseling.
Young people face similar gaps. Among adolescents with a major depressive episode in 2024, 67.7 percent of White teenagers received treatment compared with 44.7 percent of Black teenagers, as described in our report on youth mental health treatment. For veterans, see our report on veterans mental health treatment.
Treatment disparities in numbers
- 57.9 percent of White adults with a mental illness received treatment in 2024, compared with 38.5 percent of Black and 32.5 percent of Asian adults.
- Asian adults had 0.31 times the odds of White adults of being treated, after adjustment.
- 42.1 percent of men with a mental illness were treated, compared with 59.2 percent of women.
- Adults at 200 percent of the poverty line or more were treated in 55.5 percent of cases.
- Among adults with serious suicidal thoughts, 53.8 percent of the insured but only 26.1 percent of the uninsured got treatment.
- Rural adults are more likely to take medication but less likely to receive counseling.
Frequently Asked Questions
Yes. In 2024, 57.9 percent of White adults with a mental illness were treated, compared with 44.1 percent of Hispanic, 38.5 percent of Black and 32.5 percent of Asian adults.
Among groups with reliable estimates, Asian adults. SAMHSA estimated their adjusted odds of treatment at 0.31 times those of White adults in 2024.
Yes. 42.1 percent of men with a mental illness were treated in 2024, compared with 59.2 percent of women.
Yes. 55.5 percent of adults with a mental illness at 200 percent of the poverty line or more were treated in 2024, compared with 45.8 percent of those between 100 and 199 percent.
Among adults with serious suicidal thoughts in 2024, 53.8 percent of insured adults received treatment compared with 26.1 percent of the uninsured.
Rural adults take more mental health medication, 22.9 percent in 2024, but receive less counseling, 10.6 percent, than adults in large cities.
Yes. 38.5 percent of Black adults with a mental illness received treatment in 2024. Their adjusted odds of treatment were 0.47 times those of White adults.
Not clearly. The gaps seen in 2015 to 2019 were still present in 2022 to 2023 and 2024, although survey methods differ between these periods.
SAMHSA - 2024 NSDUH short report on mental health treatment among adults and adolescents.
SAMHSA - 2021 to 2023 NSDUH race and ethnicity companion report.
SAMHSA - 2021 NSDUH mental health chartbook, racial and ethnic differences 2015 to 2019.
SAMHSA - NSDUH report on mental health treatment among adults with serious suicidal thoughts.
CDC, NCHS - Data brief 419, mental health treatment among adults 2020.
CDC, NCHS - Data brief 444, mental health treatment among adults aged 18 to 44.
CDC, NCHS - Data brief 564, mental health treatment among adults 2024.