How affordable is mental health care

Since the onset of the COVID-19 pandemic, mental health has declined for many Americans, with more individuals reporting mental illness since 2019. Those diagnosed with mental illness have had disproportionate financial disadvantages and report greater financial stress. Affordable barriers exacerbate these challenges by restricting mental health access for many in need.

Among our results:

  • Several respondents have been seeking psychotherapy, behavioral health care and treatment in an emergency room for mental health needs since 2019.
  • Respondents who reported mental illness said they had a greater fear of keeping their home, especially if they have children.
  • Respondents who reported mental illness were, on average, 66 percent more likely to report debt across all categories.
  • Those who report having a mental illness but have not sought treatment are 60 percent more likely to declare mental health care unaffordable.
  • Those who reported having a mental illness said they were less likely to pursue education or further training.

The lower sense of financial security reported by those with mental illness underscores the importance of holistic care for behavioral health – not just the treatment of mental illness symptoms, but given the broader needs a person with mental illness may have. Holistic approaches, such as supportive housing and supportive employment, can improve outcomes across both health care and wider functioning of society.

A year after the pandemic began in the United States, the proportion of the population reporting signs of mental illness increased.

Our survey showed that 30 percent of all respondents reported having a mental illness. Younger generations, caregivers, and LGBTQ + respondents reported mental illness with a greater frequency.

Those with mental illness report a lower sense of financial security than those without mental illness.

Twenty percent of respondents who report mental illness reveal that they are not on track to meet short-term financial obligations
(such as rent / loans, groceries, transportation) compared to 12 percent of respondents who did not report mental illness. Inequality worsens when considering long-term economic goals
with a difference of 14 percentage points in respondents with mental illness who report that they feel off track.

Across income levels, people with mental illness are more likely to report concerns about losing their current housing, emphasizing that while access to affordable treatment and treatment outcomes is worse for low-income groups, mental illness affects individuals across socioeconomic groups.

Respondents who report a mental illness and are caregivers of children are 60 percent more likely to show concern about losing their current home than respondents who report a mental illness but are still not caregivers.

Behavioral health conditions can disrupt work, family and navigation in everyday life. The lower sense of financial security reported by those with mental illness highlights the importance of holistic care to support mental health.

Further research could help better understand the two-way relationship between debt and mental illness.

Respondents who reported mental illness were, on average, 66 percent more likely to report debt across all categories than respondents who did not report mental illness.

There is a link between mental illness and higher levels of debt and debt-related stress. This correlation can occur as a result of initial debt leading to stress and triggering an underlying susceptibility to mental illness. However, respondents reporting a mental illness may also have had a harder time maintaining a stable job, making them more likely to incur debt.


Respondents in general (including both those with and without a mental illness) report mental health services as one of the least affordable essential services.

Mental health care and childcare
were listed by the respondents as the least affordable among essential services (eg nutritious food, internet, health insurance, reliable transportation). Respondents who reported mental illness were twice as likely to perceive mental health services as unaffordable. Other studies have shown that consumers are up to 40 percent less willing to pay for mental health services than services for generic physical health conditions.

Limited affordability and willingness to pay for mental health services suggests that cost may be a core factor in limited access to mental health services.

The affordability of mental health services can be a barrier to care.

Nearly a quarter of respondents reported that they delayed health care, with a lack of affordable treatment placement as the # 1 cause.

Those who report having a mental illness but have not sought treatment for it are 60 percent more likely to declare mental health care unaffordable. This is true when checking for reported household income, as those who reported mental illness but did not seek treatment were still approximately 1.7 times more likely to report that mental health services were, on average, unaffordable.

Individuals are between five and six times more likely to use out-of-network providers for their behavioral health care needs than for physical health care – which can lead to higher out-of-pocket costs.
The lower than average reimbursement rates in the network of behavioral health providers can also lead to higher costs, as a high proportion of mental health providers do not accept insurance.
This places a greater share of the financial burden of mental health services on individuals.

Untreated mental illness can affect people’s ability to pursue education.

A study published by Mental Health America
found almost nine out of ten employees report that stress in the workplace affects their mental health and that almost three out of five employees feel that their employer does not provide a safe environment for employees living with mental illness, indicating that the workplace can be a challenging setting.

Fifty-one to 54 percent of those who report mental illness reveal that they have taken at least one day off within the last 12 months due to burnout or stress, as opposed to 15 to 18 percent of those who have not reported mental illness.

Mental health challenges ranked prominently as barriers to pursuing educational opportunities for those with mental illness.

Although there are challenges, possible actions by health care stakeholders can help those who report mental illness.

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