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America’s Mental Health Care Gap

The Affordable Care Act improved things a little for Americans with mental-health problems, but we still have a long way to go.

By Francie Diep


(Photo: 19melissa68/Flickr)

Last week, we wrote about how mentally ill Americans are disproportionately incarcerated. One survey estimated 45 percent of federal prisoners, 56 percent of state prisoners, and 64 percent of people in jail recently had symptoms of, or were diagnosed with, a mental-health disorder. Some experts have argued that the underfunding of mental health care in the United States directly led to these high incarceration rates of people with mental disorders. Instead of receiving treatment, people are getting arrested for behavior related to their conditions. Making sure folks get the mental health care they need could be a huge preventative help.

While progress has been made on that front, America still has a long way to go, according to numbers released today by the National Center for Health Statistics. On the one hand, more American adults with serious psychological distress now have health insurance compared to 2012, and fewer report being unable to afford the health care they need. Yet fewer — 34 percent in 2015, compared to 42 percent in 2012 — also report having seen a mental-health professional in the last year. Plus, Americans with psychological problems remain less likely than those without problems to have insurance and to feel like they can afford medical care.

Overall, the numbers paint a portrait of a mental health care system that has improved somewhat after the passage of the Affordable Care Act, which pushed more Americans to get health insurance and mandated equal coverage for mental and physical health care. Still, the act alone hasn’t been able to fully solve Americans’ problems with getting mental health care.

The National Center for Health Statistics report wasn’t set up to study why psychologically distressed Americans are less likely to see a professional now than they were in 2012, but other studies offer clues. Some folks may simply need more financial help beyond insurance, researchers from the Urban Institute suggest. Some may be stymied by the shortage in mental health care professionals in the United States. Still others may now be getting mental health care from their primary-care doctor, instead of a specialist.