Well-Being Mental Health

1 in 4 adults with depression or anxiety lack access to mental health services

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Story at a glance

  • A survey that took place in December 2020 suggests that many adults in the U.S. were experiencing depression or anxiety symptoms.
  • Of those adults, about 25 percent said their need for mental health counseling was not met.
  • Experts recommend medical professionals proactively screen for symptoms and policymakers include more funding for mental health services.

Mental health has come to the forefront during the pandemic as a critical health issue. Some experts are worried that young people will be affected for a long time to come. A new study published in Psychiatric Services suggests that 1 in 4 adults who are experiencing depression or anxiety are lacking mental health support during the pandemic.

The study analyzed data from the Household Pulse Survey, which was conducted in December 2020 by the U.S. Census Bureau with five other federal agencies, according to the paper.

“Social isolation, COVID-related anxiety, disruptions in normal routines, job loss, and food insecurity have led to a surge in mental illness during the pandemic,” said lead author and physician Jason Nagata, an assistant professor of pediatrics at the University of California, San Francisco, in a press release.

The survey included data from nearly 70,000 people. Participants were asked, “At any time in the last 4 weeks, did you need counseling or therapy from a mental health professional but did not get it for any reason?” Depression and anxiety symptoms were assessed according to appropriate scales. The survey also included data on age, education and household job loss since March 2020. Overall, about 18 percent of respondents fell below the federal poverty line, about 50 percent reported household job loss during the pandemic and about 61 percent had more than a high school education.

In the study, nearly 40 percent of adults reported symptoms of depression or anxiety during the pandemic. Overall, 12.8 percent of the adults in the survey said they had an unmet need for mental health counseling. This is double the estimates from previous years prior to the  pandemic, according to past studies cited in the paper. Of the adults in this study who said they experienced depression or anxiety, about 25 percent of them said they were lacking mental health support.


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Not all people have been affected by the pandemic in the same way. Subsets of the population have specific experiences that may be contributing to depression or anxiety symptoms.

“Women have disproportionately borne the burden of childcare and caregiving for older adults during the pandemic,” says Nagata. “Young adults have felt socially isolated and experienced high rates of job loss.”

This was reflected in the study results. Among adults who had depression or anxiety symptoms, people who are female, younger age, had an income below the federal poverty line, higher education or experienced household job loss during the pandemic were at higher risk of not getting the mental health counseling they needed.

What this study shows is that there is a large unmet need for mental health counseling.

“Medical professionals, social workers, and clinicians need to proactively take steps to screen for symptoms of anxiety and depression and help clients to access mental health care,” says co-author Kyle T. Ganson, an assistant professor at the University of Toronto, in the press release. “Telepsychiatry and telemental health services can improve access for people with unmet mental health needs.”

And even if people are trying to access mental health support, they may be hitting barriers to access.

“Patients have experienced several month waitlists for counseling or therapy during the pandemic,” says Nagata. “Policymakers should include more funding for mental health services as part of pandemic relief legislation and extend the use of telehealth to address the widespread unmet mental health needs of Americans.”


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