Mental health treatment facilities in the US: statistics and facts

Mental health treatment facilities at a glance

The United States had 21,205 facilities treating mental illness, substance use disorders or both in 2024, according to SAMHSA, the federal agency that runs the national census of treatment providers. Of these, 14,091 offered mental health treatment, and 8,839 of those also treated substance use disorders. The rest were facilities that only treated substance use. The survey reached 90.4 percent of eligible facilities, so the counts are close to a full census.

The facilities look very different from the asylums of the past. In 2024, 85.3 percent of mental health facilities offered outpatient care, while only 9.1 percent offered hospital inpatient care, down from 15.0 percent in 2021. Ownership is shifting too: private for-profit providers made up 29.8 percent of mental health facilities in 2024, up from 16.9 percent three years earlier.

This report covers the number of facilities, who runs them, the type of care they offer, the payment they accept and the services and age groups they serve. A summary of all related data is in our hub on mental health treatment in the US. The people who staff these facilities are covered in our report on the mental health workforce.

How many facilities are there?

The most stable measure is the total number of unique facilities treating mental illness or substance use. It has barely changed since the combined survey began: 20,622 in 2021, 21,160 in 2022, 20,681 in 2023 and 21,205 in 2024. Within that total, the number reporting mental health treatment rose from 9,050 in 2021 to 14,091 in 2024. Most of the rise came from facilities offering both services, whose number grew from 2,438 to 8,839.

A stable total: The number of treatment facilities has stayed close to 21,000 since 2021.

The older survey counted between 11,582 and 12,472 mental health facilities a year from 2017 to 2020. The lower 2021 figure does not mean thousands of facilities closed: the new survey used a different frame and a lower response rate of 78.8 percent. Comparisons across the 2021 break should therefore be made with care.

Who runs the facilities?

Most mental health facilities are privately run. In 2024, 86.0 percent were private, either non-profit or for-profit, and 14.0 percent were run by local, state, federal or tribal governments. Private non-profit organizations remain the largest group with 56.2 percent, but their share has fallen every year since 2021, when it was 64.5 percent. Over the same period the for-profit share rose by almost 13 percentage points, from 16.9 to 29.8 percent.

For-profits gain ground: Almost three in ten mental health facilities were for-profit in 2024.

Public providers have lost share. Local, county or community governments ran 5.8 percent of mental health facilities in 2024, state governments 4.4 percent and the federal government 3.0 percent. Tribal governments ran 0.8 percent, up from 0.3 percent. Combined substance use and mental health facilities lean even more toward for-profit operators: 33.9 percent of them were for-profit in 2024. Facilities that only treat substance use are covered alongside addiction trends in our report on drug use in the US.

Outpatient, residential and inpatient care

Outpatient treatment dominates. In 2024, 85.3 percent of mental health facilities offered outpatient services, 17.5 percent residential care and 9.1 percent hospital inpatient care. Facilities can offer more than one setting, so the shares add up to more than 100 percent. The share offering inpatient care has fallen steadily, from 15.0 percent in 2021 to 13.6 percent in 2022, 12.0 percent in 2023 and 9.1 percent in 2024, while the outpatient share has risen.

The shift to outpatient care: Fewer than one in ten mental health facilities offered inpatient care in 2024.

The last detailed count of clients from the older survey shows how concentrated care is in outpatient settings. On 30 April 2020, mental health facilities had 3.72 million clients enrolled: 3.59 million in outpatient care, 77,622 inpatients and 43,744 in residential care. Facilities reported 85,948 designated inpatient beds, of which 90 percent were in use, and 46,828 residential beds, 93 percent in use.

Insurance and payment accepted

Most facilities accept the main forms of insurance. In 2024, 84.5 percent of mental health facilities accepted Medicaid, 83.1 percent private health insurance and 63.5 percent Medicare. Cash or self-payment was accepted by 86.0 percent. About half, 50.9 percent, offered treatment at no charge or minimal payment for clients who could not pay, down from 54.8 percent in 2021. The Medicaid share also slipped, from 87.9 percent in 2021.

Medicaid widely accepted: More than eight in ten facilities take Medicaid patients.

Medicare acceptance is notably lower than Medicaid or private insurance, which matters for older adults. Medicare is the main insurer for adults aged 65 and older. How cost and insurance shape who gets care is covered in our reports on mental health treatment disparities and untreated mental illness.

Services and groups served

Beyond the basic setting, facilities differ widely in what they offer. In 2024, 80.4 percent of mental health facilities provided care for people with both a serious mental illness or emotional disturbance and a substance use disorder, and 63.4 percent ran programs tailored to co-occurring disorders. Suicide prevention services were offered by 68.4 percent, and 60.2 percent prescribed antipsychotic medication for serious mental illness.

Children less served: Fewer than a third of facilities had programs for children and adolescents with serious emotional disturbance.

Programs for specific age groups are less common. Only 31.8 percent of facilities had programs for children and adolescents with serious emotional disturbance, 36.2 percent for young adults and 36.7 percent for seniors. Almost all facilities, 97.2 percent, were licensed, certified or accredited. The treatment of young people is covered in our report on youth mental health treatment.

Suicide prevention by state

The availability of services varies between states. In 47 states and territories, more than 60 percent of mental health facilities offered suicide prevention services in 2024. Oklahoma had the highest share at 89.8 percent, followed by South Dakota at 89.1 percent and Wyoming at 87.8 percent. Nationally, the share has been close to 70 percent since 2021.

Oklahoma leads: Nine in ten mental health facilities in Oklahoma offered suicide prevention services.

Facilities are only one part of the picture. A facility can only treat as many people as it has staff, and many regions lack psychiatrists and therapists, as our report on the mental health workforce shows. How many adults actually receive care is covered in our report on adults receiving mental health treatment, and the treatment of veterans, many of whom use federal VA facilities, in our report on veterans mental health treatment.

Mental health facilities in numbers

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