More than half of Americans say their mental health became important to them in the last five years, a new survey found.
Conducted in April by Rula Health, a virtual behavioral health company, the survey reached more than 2,000 U.S. adults and aimed to understand the current state of mental health.
The findings revealed more than half of Americans have accessed mental health services at some point in their lives. Of those, more than a quarter are currently in therapy and another quarter sought therapy within the past year.
This is an encouraging sign that people are proactively addressing their mental health concerns, the report suggested. And many respondents are seeing progress: 78% of those who sought therapy said they saw improvement as a result.
Respondents' top reasons for seeking support include economic uncertainty (28%), social issues and discourse (27%) and political changes (15%). Another 13% cited COVID-19 as inspiring them to speak about their mental health.
For more than half of respondents, the top reasons for getting care were anxiety and depression. This was followed by stress and burnout (33%), trauma (27%), relationship issues (25%), grief or loss (24%) and work-related pressures (15%).
A third of people ages 18-24 are seeking therapy due to trauma, “a reflection of the broader existential crisis this generation has faced,” Doug Newton, M.D., M.P.H., Rula’s chief medical officer, told Fierce Healthcare. “From the pandemic to social injustice, climate anxiety, and economic uncertainty, today’s young adults are navigating a near-constant state of stress. Providers must be equipped to offer trauma-informed care that’s accessible, validating, and grounded in real-world experiences.”
The cost of care remains a major barrier to access, the survey found: a quarter of respondents said the cost of care would discourage them from seeking support. Of those not currently in treatment, nearly a fifth stopped going to therapy because it got too expensive and 16% stopped because their insurance coverage changed or ended.
Other barriers to care include not finding the right therapist (16%), availability and time constraints (12%), distrust of the medical system (11%) and stigmas around mental health (7%).
Older adults, in particular, appear to be struggling to access care. More than half of respondents 65 and older have not had treatment in more than five years and 28% said they are unsure what kind of therapy would be most helpful for them. This age group was also most likely to report being uncomfortable speaking about their mental health.
“There’s a persistent misconception that older adults aren’t interested in mental healthcare, but the data tells a different story,” Newton said. “For many, it’s not a lack of interest, it’s stigma, affordability, and confusion about how to get started. Integrating mental health support into primary care and normalizing these conversations can help bridge the gap for this generation.”
The survey revealed the pros and cons of technology: two-thirds of respondents said tech impacts their mental health in some way while more than a fifth said that tech makes them feel more connected to the world. Of those who skewed negatively, a quarter felt overloaded by information, more than a fifth felt a constant need to be online and a fifth felt less connected to those around them.
Nearly a quarter of respondents prefer telehealth over in-person therapy. When it comes to how people find their therapist, the most common way was online search, followed by a referral from their physician and then a referral from friends and family. Nearly 6% found their therapist using AI programs like ChatGPT.
Gen Z, the most active generation on social media, was the group most likely to express distrust in the medical system as a reason for not seeking mental healthcare. Certain wellness trends on social media may be steering them away from clinical care.
“We’re seeing a real crisis of trust among Gen Z, and it’s deeply affecting how and if they seek mental health care,” Newton said. “This generation grew up online, where misinformation about healthcare spreads quickly, and that’s influencing their perception of traditional medical systems.”
Newton recommends that providers serve younger patients through digital platforms or by building culturally responsive, transparent care models: “Rebuilding Gen Z’s trust starts with listening.”
Overall, the most common factors influencing people’s relationship with their mental health was their social circle and family and friends. More than half of respondents also said mental health is very important to their close ones, “a clear sign that positive change is taking root,” per the report.
“Each generation faces unique challenges when it comes to mental health, and our care systems must evolve to reflect that,” Newton said. “If we want to close the mental health gap, we must deliver care that feels personal, not clinical, and meet people where they are, with empathy, cultural competency, and innovation.”