By Deidre McPhillips, CNN
Updated: Wed, 05 Oct 2022 15:17:17 GMT
An overwhelming majority of people in the United States think the country is experiencing a mental health crisis, according to a new survey from CNN in partnership with the Kaiser Family Foundation.
Nine out of 10 adults said they believed that there's a mental health crisis in the US today. Asked to rate the severity of six specific mental health concerns, Americans put the opioid epidemic near the top, with more than two-thirds of people identifying it as a crisis rather than merely a problem. More than half identified mental health issues among children and teenagers as a crisis, as well as severe mental illness in adults.
The survey captured the perceptions of a nationally representative sample of about 2,000 adults over the summer -- 2½ years into the Covid-19 pandemic and amid ongoing public health threats including racism and gun violence.
The broad concern is well-founded, rooted in both personal experience and national trends.
"The Covid-19 pandemic exacerbated numerous social stressors that we know can increase the risk of both substance use and mental illness," said Dr. Nora Volkow, director of the National Institute on Drug Abuse.
Data from the US Centers for Disease Control and Prevention shows that drug overdose deaths reached record levels in 2021 and suicide rates were back near a record high after two years of decline. And in 2020, mental health-related visits to emergency rooms jumped 31% among adolescents ages 12 to 17.
According to the CNN and KFF poll, about half of adults say they have had a severe mental health crisis in their family, including in-person treatment for family members who were a threat to themselves or others, or family members who engaged in self-harming behaviors.
More than 1 in 5 adults describe their own mental health as only "fair" or "poor," including extra-large shares of adults under the age of 30, adults who identify as LGBT and those with an annual income of less than $40,000. A third of all adults said they felt anxious always or often over the course of the past year, including more than half of LGBT adults and those under 30. About 1 in 5 adults said they were often or always depressed or lonely over the past year, too.
Major sources of stress for a third or more of adults include personal finances and current and political events. About 1 in 4 adults also identified personal relationships and work, respectively, as major sources of stress.
According to the new survey, about 1 in 5 adults received mental health services in the past year. Earlier data published by the CDC supports that finding and shows that mental health treatment became more common over the course of the pandemic: Nearly 22% of adults got mental health treatment in 2021, up from about 19% in 2019.
"Perhaps one of the only benefits of the pandemic and the shift that our country has been going through is the increase in our willingness to acknowledge and talk about when we might be struggling or in need of support," said Sarah Brummett, director of the National Action Alliance for Suicide Prevention's executive committee.
"People are more willing to roll up their sleeves and talk about it and support folks. And I think that's progress."
Despite increased willingness and commonly shared stressors among the public, most adults who have only fair or poor mental health said they don't feel comfortable talking to loved ones about it -- some to maintain privacy and some to avoid the shame and stigma attached to mental health issues.
But the vast majority -- more than 4 out of 5 -- of those surveyed say individuals and families should play a major role in addressing mental health problems in the US, equal to the share who say the same of health care providers.
Experts say there is an opportunity to broaden perceptions about how mental health is part of overall physical health and how to respond to mental health crises.
"Not everyone's a cardiologist, but a lot of people are trained in CPR," said Justin Baker, a psychologist and assistant professor at the Ohio State University College of Medicine. "If we only rely on the mental health force, we're going to keep going around in circles and never actually get anywhere. I think we see this as all of our problems."
Nonetheless, the groups most likely to say they need mental health care in the US are also less likely to say they can get it.
Nearly 6 out of 10 adults who say their mental health is only fair or poor say they have not been able to get needed care, as well as about half of adults younger than 30 and LGBT adults.
For those who have gone without help, the most common reasons cited were being too busy or unable to take time off work, being unable to afford the cost, and being afraid or embarrassed to seek care, according to the CNN and KFF survey.
In his first State of the Union address, President Joe Biden outlined a multipronged strategy to address the country's mental health crisis, including goals to integrate mental health into primary care, investing in the work force and new approaches to programs that provide care.
"Let's get all Americans the mental health services they need, more people they can turn to for help and full parity between physical and mental health care," he said in his address in March.
According to the poll, most Americans see those issues as significant problems. A majority, 55%, say it's a big problem that there aren't enough mental health care providers, about three-quarters say that insurers not covering mental health the way they do physical health is a significant concern, and 80% say the same about the cost of mental health care.
Through the American Rescue Plan, the Biden administration has invested $5 billion in mental health and substance use programs through the US Department of Health and Human Services, with billions more proposed in future budgets.
One significant shift came this summer, with the transition of the National Suicide Prevention Lifeline to a three-digit dialing code: 988. Early data suggests success, with calls jumping 45% in the first month compared with the same time a year before.
But according to the new survey, there is still work to be done.
The vast majority of adults (85%) say they would be at least somewhat likely to call the hotline if they or a loved one were experiencing a mental health crisis -- and it's a good alternative to 911, which about a quarter of adults, especially Black and LGBT adults, say would do more harm than good in a mental health crisis situation.
It also has potential to help Hispanic people and those who are uninsured, who are more likely than average to say they don't know who to call if there is a mental health crisis and would not know where to find services.
Yet more than half of adults in the new poll say they have heard "nothing at all" about the new 988 hotline.
"This can be a preventable public health issue, and we all have a role to play," Brummett said.
The fieldwork for the CNN/KFF Mental Health Survey was conducted by SSRS on July 28 through August 9 among a random national sample of 2,004 adults. The poll includes 1,603 adults who were surveyed online after being recruited using probability-based methods and 401 adults who were selected by random digit dialing and reached on landlines or cellphones by a live interviewer. Results for the full sample have a margin of sampling error of plus or minus 3 percentage points.