Mental Health Treatment Among Adults: United States, 2019

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Emily P. Terlizzi, M.P.H., and Benjamin Zablotsky, Ph.D.

Key findings

Data from the National Health Interview Survey

• In 2019, 19.2% of adults had received any mental health treatment in the past 12 months, including 15.8% who had taken prescription medication for their mental health and 9.5% who received counseling or therapy from a mental health professional.
• Women were more likely than men to have received any mental health treatment.
• Non-Hispanic white adults (23.0%) were more likely than non-Hispanic black (13.6%) and Hispanic (12.9%) adults to have received any mental health treatment.
• Overall, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased.

In 2018, about 19% of adults experienced any mental illness in the past year, defined as having any mental, behavioral, or emotional disorder in the past year that met criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or DSM–IV, excluding developmental or substance use disorders (1,2). This report describes the percentage of U.S. adults who have taken prescription medication for their mental health or have received counseling or therapy from a mental health professional in the past 12 months by select characteristics, based on data from the 2019 National Health Interview Survey (NHIS). Estimates are also presented for any mental health treatment, defined as having taken medication for mental health, received counseling or therapy, or both in the past 12 months.

Keywords: medication, counseling and therapy, National Health Interview Survey (NHIS)

The percentage of adults who had received any mental health treatment varied by age group.

Figure 1. Percentage of adults aged 18 and over who had received any mental health treatment, taken medication for their mental health, or received counseling or therapy from a mental health professional in the past 12 months, by age group: United States, 2019

¹Significant quadratic trend by age group (p < 0.05).
²Significant linear trend by age group (p < 0.05).
NOTES: Adults were considered to have received any mental health treatment if they reported having taken medication for their mental health, received counseling or therapy from a mental health professional, or both in the past 12 months. Adults were asked separately if they took prescription medication for feelings of anxiety, for depression, or to help with any other emotions or with their concentration, behavior, or mental health. Adults who responded positively to any of these three questions were considered to have taken medication for their mental health in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population. Access data table for Figure 1.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2019.

Women were more likely than men to have received any mental health treatment.

• Nearly one in four women received any mental health treatment (24.7%) in the past 12 months, compared with 13.4% of men (Figure 2).
• Women were more likely than men to have taken medication for their mental health (20.6% and 10.7%, respectively) and to have received counseling or therapy from a mental health professional (11.7% and 7.2%) in the past 12 months.

Figure 2. Percentage of adults aged 18 and over who had received any mental health treatment, taken medication for their mental health, or received counseling or therapy from a mental health professional in the past 12 months, by sex: United States, 2019

¹Significantly different from women (p < 0.05).
NOTES: Adults were considered to have received any mental health treatment if they reported having taken medication for their mental health, received counseling or therapy from a mental health professional, or both in the past 12 months. Adults were asked separately if they took prescription medication for feelings of anxiety, for depression, or to help with any other emotions or with their concentration, behavior, or mental health. Adults who responded positively to any of these three questions were considered to have taken medication for their mental health in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population. Access data table for Figure 2.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2019.

The percentage who had received any mental health treatment was highest among non-Hispanic white adults.

• Non-Hispanic white adults were most likely to have received any mental health treatment in the past 12 months (23.0%) compared with other race and Hispanic-origin groups (Figure 3).
• Non-Hispanic white adults (19.1%) were more likely than non-Hispanic black (11.1%) and Hispanic (10.3%) adults to have taken medication for their mental health.
• Non-Hispanic white adults (10.9%) were also most likely to have received counseling or therapy compared with the other race and Hispanic-origin groups.
• Non-Hispanic black adults (8.1%) were more likely to have received counseling or therapy compared with Hispanic adults (6.6%).

Figure 3. Percentage of adults aged 18 and over who had received any mental health treatment, taken medication for their mental health, or received counseling or therapy from a mental health professional in the past 12 months, by race and Hispanic origin: United States, 2019

¹Significantly different from non-Hispanic white adults (p < 0.05).
²Significantly different from non-Hispanic black adults (p < 0.05).
NOTES: Adults were considered to have received any mental health treatment if they reported having taken medication for their mental health, received counseling or therapy from a mental health professional, or both in the past 12 months. Adults were asked separately if they took prescription medication for feelings of anxiety, for depression, or to help with any other emotions or with their concentration, behavior, or mental health. Adults who responded positively to any of these three questions were considered to have taken medication for their mental health in the past 12 months. Adults categorized as Hispanic may be of any race or combination of races. Adults categorized as non-Hispanic white or non-Hispanic black indicated one race only. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population. Access data table for Figure 3.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2019.

The percentage of adults who had received any mental health treatment varied by urbanization level.

• The percentage of adults who had received any mental health treatment in the past 12 months increased as the place of residence became more rural, from 17.9% among those living in large metropolitan areas to 21.5% among those living in nonmetropolitan areas (Figure 4).
• The percentage of adults who have taken medication for their mental health also increased as the place of residence became more rural, from 14.2% among those living in large metropolitan areas to 18.9% among those living in nonmetropolitan areas.
• The percentage of adults who received counseling or therapy from a mental health professional in the past 12 months was lower in nonmetropolitan areas (7.8%) compared with medium or small metropolitan areas (9.9%) and large metropolitan areas (9.7%).

Figure 4. Percentage of adults aged 18 and over who had received any mental health treatment, taken medication for their mental health, or received counseling or therapy from a mental health professional in the past 12 months, by urbanization level: United States, 2019

¹Significant linear trend by urbanization level (p < 0.05).
²Significant quadratic trend by urbanization level (p < 0.05).
NOTES: Adults were considered to have received any mental health treatment if they reported having taken medication for their mental health, received counseling or therapy from a mental health professional, or both in the past 12 months. Adults were asked separately if they took prescription medication for feelings of anxiety, for depression, or to help with any other emotions or with their concentration, behavior or mental health. Adults who responded positively to any of these three questions were considered to have taken medication for their mental health in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population. Access data table for Figure 4.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2019.
 

Summary

In 2019, 19.2% of U.S. adults received any mental health treatment in the past 12 months, including 15.8% who had taken prescription medication for their mental health and 9.5% who had received counseling or therapy from a mental health professional. While the percentage of adults who had taken medication for their mental health increased with age, the percentage who had received counseling or therapy decreased with age.

Women were more likely than men to have received any treatment for their mental health, consistent with the higher prevalence of common mental health conditions, such as anxiety and depression, seen among women (3) as well as an increased willingness to seek mental health care (4). Receipt of any mental health treatment was higher among non-Hispanic white adults compared with non-Hispanic black and Hispanic adults. While the percentage of adults who had received counseling or therapy decreased as level of urbanization decreased, the percentage who had taken medication for their mental health increased with decreasing urbanization level.

The findings shown are consistent with previous studies regarding differences by age in medication use and receipt of mental health care (4,5), disparities by race and ethnicity (6), and differences by urbanization level. Past research has shown that nonmetropolitan, or more rural, counties have a lower supply of mental health professionals per capita (7) but a higher prevalence of adults who had experienced a mental illness compared with metropolitan, or more urban, counties (8).

Definitions

Any mental health treatment: A composite measure of adults who reported having taken medication for their mental health, received counseling or therapy from a mental health professional, or both in the past 12 months.

Race and Hispanic origin: Adults categorized as Hispanic may be of any race or combination of races. Adults categorized as non-Hispanic white or non-Hispanic black indicated one race only.

Received therapy or counseling, past 12 months: Based on a positive response to the question, “During the past 12 months, did you receive counseling or therapy from a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?”

Taken medication for mental health, past 12 months: Sample adults were asked how often they felt worried, nervous, or anxious, followed by the question, “Do you take prescription medication for these feelings?” They were also asked how often they felt depressed, followed by, “Do you take prescription medication for depression?” Those who answered that they did not take medication for feelings of either anxiety or depression (or who did not know or refused to answer these two questions) were later asked, “During the past 12 months, did you take prescription medication to help you with any other emotions or with your concentration, behavior, or mental health?” Adults who responded positively to any of these three questions were considered to have taken medication for their mental health in the past 12 months.

Urbanization level: Metropolitan size and status was determined using the 2013 NCHS urban–rural classification scheme for counties (9), by merging the geographic federal information processing standard (FIPS) codes for the county of household residence with the county-level FIPS codes from the classification scheme’s data set. Large metropolitan includes large central and large fringe metropolitan counties. Medium or small metropolitan includes medium and small metropolitan counties. Nonmetropolitan includes micropolitan and noncore counties

Data source and methods

Data from the 2019 NHIS were used for this analysis. NHIS is a nationally representative household survey of the U.S. civilian noninstitutionalized population. It is conducted continuously throughout the year by the National Center for Health Statistics (NCHS). Interviews are conducted in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. For more information about NHIS, visit: https://www.cdc.gov/nchs/nhis.htm.

Point estimates and the corresponding confidence intervals for this analysis were calculated using SUDAAN software (10) to account for the complex sample design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Trends by age group and urbanization level were evaluated using orthogonal polynomials in logistic regression. All estimates meet NCHS data presentation standards for proportions (11).

About the authors

Emily P. Terlizzi and Benjamin Zablotsky are with the National Center for Health Statistics, Division of Health Interview Statistics.

References

1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. HHS Publication No. PEP19-5068, NSDUH Series H-54. Rockville, MD: Center for Behavioral Health Statistics and Quality. 2019.
2. American Psychiatric Association. DSM–IV: Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC. 1994.
3. Eaton NR, Keyes KM, Krueger RF, Balsis S, Skodol AE, Markon KE, et al. An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. J Abnorm Psychol 121(1):282–8. 2012.
4. MacKenzie CS, Gekoski WL, Knox VJ. Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging Ment Health 10(6):574–82. 2006.
5. Moore TJ, Mattison DR. Adult utilization of psychiatric drugs and differences by sex, age, and race. JAMA Intern Med 177(2):274–5. 2017.
6. Substance Abuse and Mental Health Services Administration. Racial/ethnic differences in mental health service use among adults. HHS Publication No. SMA-15-4906. Rockville, MD. 2015.
7. Andrilla CHA, Patterson DG, Garberson LA, Coulthard C, Larson EH. Geographic variation in the supply of selected behavioral health providers. Am J Prev Med 54(6 Suppl 3):S199–S207. 2018.
8. Meit M, Knudson A, Gilbert T, Yu ATC, Tanenbaum E, Ormson E, et al. The 2014 update of the rural–urban chartbook. Bethesda, MD: Rural Health Reform Policy Research Center. 2014.
9. Ingram DD, Franco SJ. 2013 NCHS urban–rural classification scheme for counties. National Center for Health Statistics. Vital Health Stat 2(166). 2014.
10. RTI International. SUDAAN (Release 11.0.3) [computer software]. 2018.
11. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez JF Jr, et al. National Center for Health Statistics data presentation standards for proportions. National Center for Health Statistics. Vital Health Stat 2(175). 2017.

Suggested citation

Terlizzi EP, Zablotsky B. Mental health treatment among adults: United States, 2019. NCHS Data Brief, no 380. Hyattsville, MD: National Center for Health Statistics. 2020.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Brian C. Moyer, Ph.D., Director
Amy M. Branum, Ph.D., Acting Associate Director for Science

Division of Health Interview Statistics

Stephen J. Blumberg, Ph.D., Director
Anjel Vahratian, Ph.D., M.P.H., Associate Director for Science