Untreated mental illness in the US: statistics and facts

Untreated mental illness at a glance

Nearly half of American adults with a mental illness receive no treatment for it. According to the 2025 National Survey on Drug Use and Health, 54.6 million adults, or 20.6 percent of all adults, had any mental illness in the past year. Of these, 27.8 million, or 50.9 percent, received mental health treatment, while 26.9 million, or 49.1 percent, did not. Among the 18.2 million adults with a serious mental illness, the treatment rate is higher at 67.7 percent, but about 5.9 million still went without care.

The gap is larger among people who also struggle with substance use. Of the 18.5 million adults with both a mental illness and a substance use disorder in 2025, 42.6 percent, about 7.9 million, received neither mental health nor substance use treatment. Large differences also exist between groups: in 2024, 57.9 percent of White adults with a mental illness received treatment, but only 38.5 percent of Black adults and 32.5 percent of Asian adults.

This report looks at who goes untreated, how the gap differs by race, sex and age, the role of cost and the shortage of mental health professionals, and what is known about co-occurring disorders. Our hub on mental health treatment in the US gives the overall picture; the people who do receive care are covered in our report on adults receiving mental health treatment.

Half of adults with mental illness go untreated

Mental illness is most common among young adults. In 2025, 28.6 percent of adults aged 18 to 25 had any mental illness, compared with 27.1 percent of those aged 26 to 49 and 12.8 percent of those aged 50 and older. Overall, 57.3 million adults, or 21.6 percent of the adult population, received some mental health treatment in the past year, including people without a diagnosable mental illness. According to SAMHSA, prescription medication was the most common form of treatment.

Almost evenly split: 27.8 million adults with a mental illness were treated, 26.9 million were not.

The treatment gap is not new, but it remains large. Because of changes in the survey, SAMHSA does not compare the 2025 treatment rate with earlier years. For reference, the 2024 survey, on its own basis, found 52.1 percent of adults with any mental illness in treatment. Women were far more likely than men to receive treatment in 2024: 59.2 percent compared with 42.1 percent.

Serious mental illness

People with a serious mental illness, such as severe depression, bipolar disorder or schizophrenia, are more likely to receive care, but one in three does not. In 2025, 12.3 million of the 18.2 million adults with a serious mental illness received mental health treatment, 67.7 percent. About 5.9 million did not. Of these untreated adults, 40.5 percent, about 2.3 million, said they had needed mental health care in the past year but not received it.

One in three untreated: About 5.9 million adults with a serious mental illness received no treatment.

Serious mental illness is concentrated among younger adults. In 2025, 12.1 percent of those aged 18 to 25 had a serious mental illness, compared with 9.6 percent of those aged 26 to 49 and 3.0 percent of those aged 50 and older. Serious thoughts of suicide were reported by 13.9 million adults, or 5.3 percent, in 2025, and 2.3 million adults made a suicide attempt.

Who is most likely to go untreated?

Race and ethnicity make a large difference. In 2024, 57.9 percent of White adults with any mental illness received treatment, compared with 52.0 percent of multiracial adults, 44.1 percent of Hispanic adults, 38.5 percent of Black adults and 32.5 percent of Asian adults. In other words, about six in ten Black adults and two in three Asian adults with a mental illness went untreated, by BusinessStats calculation. Differences by age were small and not statistically significant.

A wide racial gap: Asian adults with a mental illness were treated only about half as often as White adults.

Lesbian, gay and bisexual adults report higher rates of mental illness. According to SAMHSA, about three in four LGB adults with a serious mental illness received treatment in 2023, and 4.9 million LGB adults, 23.8 percent, had both a mental illness and a substance use disorder. A deeper look at differences by insurance, income and group is in our report on mental health treatment disparities.

Mental illness and substance use

Many people with a mental illness also have a substance use disorder, and they are especially likely to fall through the gaps. In 2025, 18.5 million adults had both. Only 57.4 percent received either mental health or substance use treatment, and of those who were treated, 72.9 percent received only mental health treatment. Among the 7.8 million adults with a serious mental illness and a substance use disorder, 28.7 percent received neither form of treatment. Substance use itself is covered in our report on drug use in the US.

Roughly stable: About 7 to 8 percent of adults have both conditions each year.

Two in five untreated: 42.6 percent of adults with any mental illness and a substance use disorder received no treatment.

Cost and the shortage of providers

Cost is one reason people go without care. According to preliminary estimates from the CDC National Health Interview Survey, 5.4 percent of adults did not get mental health care they needed in 2025 because of the cost. Among adults with serious suicidal thoughts in 2024, insurance made a large difference: 53.8 percent of the insured received treatment, but only 26.1 percent of the uninsured.

Where people live matters too. Adults in nonmetropolitan areas were less likely to receive counseling in 2024, 10.6 percent, than those in large cities, 15.2 percent, but more likely to take prescription medication, 22.9 compared with 16.7 percent. Across the country, 157.1 million people lived in a federally designated mental health professional shortage area in June 2026, up from 122.4 million in June 2024, and roughly three quarters of the need there went unmet. More on staffing is in our report on the mental health workforce, and on providers in our report on mental health treatment facilities.

157 million people: Almost half of all Americans live in an area short of mental health professionals.

Untreated depression among adolescents

The treatment gap also affects young people. In 2025, 3.7 million adolescents aged 12 to 17 had a major depressive episode, and 42.3 percent of them, about 1.6 million, received no mental health treatment. Among those untreated, 41.7 percent said they had needed care. Treatment of children and teenagers is covered in our report on youth mental health treatment, and the situation at universities in our report on college student mental health.

Untreated mental illness in numbers

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