34% of US Adults With Mental Illness Received ‘Minimally Adequate Care’

Most U.S. adults with a psychiatric disorder now reach mental health treatment of some kind. Far fewer receive enough care to meet a minimum standard of adequacy. Researchers found that even though the number of co-occurring disorders declined overall since 2021, 61% of adults with a past-year psychiatric illness received treatment, while only 34% received care considered minimally adequate. 

For anyone comparing behavioral treatment centers or trying to judge whether a program is doing enough, that gap is the practical finding. It comes at a time when a national provider shortage has gripped the nation, leaving many vulnerable populations without access to long-term care.

The Study’s Findings

The Mental and Substance Use Disorders Prevalence Study, known as MDPS, collaborated with RTI International to supervise the study. Funds for the research came from SAMHSA

Rather than relying on self-report alone, trained clinicians conducted structured clinical interviews with 4,764 adults aged 18 to 65, drawn from a multistage clustered household sample of the US population. Data came from cases from 2020 to 2022. Clinicians asked participants about inpatient and outpatient visits, and psychiatric medications over the previous year.

That method matters. Clinical interviews tend to produce different prevalence estimates than survey questionnaires. That’s partly why these results read higher than prior national surveys on treatment receipt.

The Gap Shows Up

Nearly one in four participants, 25%, had a past-year psychiatric disorder. Major depressive disorder was the most common at 15.4%, followed by generalized anxiety disorder at 10%.

The pattern held for depression and anxiety. Among adults with major depressive disorder, 59.5% received any treatment and 37% received minimally adequate treatment. Among adults with generalized anxiety disorder, nearly 66% received any treatment and 40% met the adequacy threshold.

The study also found differences by demographic group. Adult men, alongside Blacks and Latinos had less likelihood than their peer groups to receive treatment at all, let alone minimally adequate treatment when they did get help.

Co-author Dr. Leyla Stambaugh, a developmental psychologist at RTI, framed the takeaway around sufficiency rather than access. She relayed that “access is only part of the story.”

Mental Health Connects with Addiction

MDPS measures psychiatric and substance use disorders, and its name reflects that dual scope. The findings summarized here concern psychiatric disorders and mental health treatment specifically.

The adequacy question carries particular weight for people with co-occurring disorders, meaning a mental health condition joined with a substance use disorder. When someone is treated for depression while an untreated alcohol or opioid problem continues or the reverse, the treated condition tends to destabilize. 

Adequacy of care doesn’t just apply to dosing questions in that situation. Researchers probed whether patients and providers addressed the whole clinical picture. Indeed, the mental health provider shortage has also led to gaps in treatment among those who have substance use disorders.

Dual Diagnosis

Dual diagnosis describes a mental health condition and a substance use disorder occurring together in the same person. Integrated treatment addresses both in one coordinated plan and a single team, rather than sending someone to separate programs that do not talk to each other.

Integrated care is generally the recommended approach for co-occurring conditions. Sequential or parallel treatment tends to leave one condition unmanaged while the other is being worked on.

Treatment Options

Levels of care range from various levels of outpatient therapy to residential treatment centers. Which level fits depends on symptom severity, safety, medical needs, and whether someone has stable housing and aftercare.

The adequacy finding suggests a useful screening question when you contact a program. Ask what a full course of treatment looks like there, not just the intake process. Inquire how many sessions, over what period, and how the program decides someone is ready to step down.

Finding the Right Care

If you’re searching for mental health treatment facilities or dual diagnosis programs, useful next steps include:

• Ask whether a program screens for both mental health and substance use conditions at intake
• Confirm that the same team treats both, rather than referring one out
• Check which evidence-based therapies are offered and how frequently
• Verify insurance, Medicaid acceptance, and what happens if you need a longer course of care
• Call or text 988 if you or someone you love is in crisis

Thar’s where our directory comes in. You can browse our comprehensive listings of mental health, behavioral health, and dual diagnosis treatment centers nationwide. You can also dial 800-908-4823 (Sponsored) for help comparing comprehensive treatment options.

Author

Terri Beth Miller, PhD

Author, Award-Winning Post-Secondary Teacher

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Terri Beth received her PhD in English literature from the University of Tennessee Knoxville and is an educator and disability studies scholar. For more than a decade, she has written extensively in the fields of mental health and addiction recovery and fiercely advocates for the destigmatization of mental illness.

Editor

Peter Lee, PhD

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Peter W.Y. Lee is a writer and historian of American history during the Cold War. His primary focus is the relationship between youth and popular culture and its impact on U.S. society during the twentieth century. He has published widely on how the public has used popular culture as a mechanism to address political and social shifts throughout time