Americans perceive mental health treatment as inferior to physical health care, survey reveals

Three-quarters of Americans feel mental health conditions are identified and treated much worse than physical health issues within the U.S. healthcare system, even as more than 80% perceive a dramatic rise in prevalence of mental health issues in the last five years, according to a new survey from West Health and Gallup released at the start of Mental Health Awareness Month and Older Americans Month.

Nearly identical percentages believe mental health is handled either "much" (38%) or "somewhat" worse (37%) than physical health ailments, while 15% say they are dealt with "about the same." Just 5% think mental health is treated "somewhat" (4%) or "much" better (1%). This negative assessment of mental healthcare comes as 4 in 5 Americans perceive an increase in conditions such as depression or anxiety over the past five years, including 42% who think they have increased a lot.

These latest findings may explain why 57% of Americans give poor to failing grades to the nation's healthcare system for its handling of mental health conditions -- 32% give it a "D" and 25% give it an "F." Only 1% awarded the top grade of "A", with 8% giving it a "B" and 27% a "C."

Many Americans struggle with mental and behavioral health conditions that often go unaddressed in the context of treating and managing other medical conditions. Health systems, providers, caregivers and patients themselves need to pay just as much attention to mental health as they grow older as they do their physical health. The two are inextricably linked and critical to overall health, aging successfully and quality of life."

Timothy Lash, President, West Health

According to the CDC, depression is more common in people who have other illnesses. About 80% of older adults have at least one chronic health condition, and 50% have two or more. Notably, the West Health-Gallup survey finds a higher percentage of older adults than the general population (82% vs. 75%) feel mental health issues are not treated as they should. This is a particularly important finding in that come 2030, people 65 and older will outnumber children for the first time in the U.S. and increase the demand for mental health services.

The survey finds 51% of Americans say they have experienced depression, anxiety or some other mental or emotional condition in the past 12 months. This group includes 22% who say their condition was so significant that it disrupted their normal activities, such as going to work or taking care of their household. 

Over half of Americans see psychological counseling (53%) as an effective treatment and 35% say the same of prescription medication. But two potential barriers including lack of affordability (52%) and difficulty in accessing a provider (42%) may be preventing people from seeking care. Other barriers or reasons include a belief that the individual can deal with their condition on their own (28%), shame or embarrassment (27%) or not thinking treatment would help (24%).

Seven in 10 Americans report societal stigma around mental illness, which also played a role in keeping people from getting professional help. The belief is strongest among those who say they have dealt with a mental health condition in the past year (74%) and older adults (75%).

"Effectively meeting the behavioral health needs of Americans and their families throughout the different stages of life requires providers, caregivers, policymakers, payers and patients themselves work together to reduce barriers to care," said Lash. "There are still sizable numbers of people not getting the treatment they need – a situation that may only worsen as the population ages. Effective approaches, including integrated and person-centered models of behavioral health that deliver services through clinics or community-based organizations, should be more fully leveraged to ensure people are able to get the care they need when and where they need it."

Since 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) called for health plans to cover mental health benefits to the same level they cover general healthcare. But according to the White House, "too many Americans still struggle to find and afford the care they need." In 2020, the government reported less than half of those with a mental illness received care for it.

Last year, the Biden administration highlighted mental health as a priority with a "comprehensive national strategy to transform how mental health is understood, accessed, treated, and integrated in and out of health care settings," which includes expanding access to mental health services from Medicare.

Methodology

Results for this Gallup poll are based on self-administered web surveys conducted Feb. 2-14, 2024 with a random sample of 2,266 adults, aged 18 and older, and are members of the Gallup Panel. Gallup uses probability-based, random sampling methods to recruit its Panel members. For results based on the sample of U.S. adults, the margin of sampling error is ±3 percentage points at the 95% confidence level.