This is according to a new survey by West Health, a US health network focused on ageing and healthcare, and analytics and advisory firm Gallup. The poll’s findings were released at the start of Mental Health Awareness Month and Older Americans Month.

Nearly identical percentages believe mental health is handled either “much” (38 per cent) or “somewhat” worse (37 per cent) than physical health ailments, while 15 per cent say they are dealt with “about the same.” Just 5 per cent think mental health is treated “somewhat” (4 per cent) or “much” better (1 per cent).

This negative assessment of mental healthcare comes as four in five Americans perceive an increase in conditions such as depression or anxiety over the past five years, including 42 per cent who think they have increased a lot.

Against this backdrop, 57 per cent of Americans mark the US healthcare system poorly for its handling of mental health conditions – 32 per cent give it a “D” and 25 per cent an “F.” A mere 1 per cent awarded the top grade of “A”, with 8 per cent giving it a “B” and 27 per cent a “C.”

“Many Americans struggle with mental and behavioural health conditions that often go unaddressed in the context of treating and managing other medical conditions,” said Timothy Lash, president of West Health. “Health systems, providers, caregivers and patients themselves need to pay just as much attention to mental health as they grow older as they do their physical health. The two are inextricably linked and critical to overall health, ageing successfully, and quality of life.”

According to the Centers for Disease Control and Prevention, depression is more common in people who have other illnesses. About 80 per cent of older adults have at least one chronic health condition, and half have two or more. Notably, the West Health-Gallup survey finds a higher percentage of older adults than the general population (82 per cent versus 75 per cent) feel mental health issues are not treated as they should. This significant because by the end of the decade, people 65 and older will outnumber children for the first time in the US, leading to a likely increase in demand for mental health services.

The survey finds 51 per cent of Americans say they have experienced depression, anxiety or some other mental or emotional condition in the past 12 months. This group includes 22 per cent who say their condition was so significant that it disrupted their normal activities, such as going to work or taking care of their household.  

Treatments and barriers to access

Over half of Americans see psychological counselling (53 per cent) as an effective treatment and 35 per cent say the same of prescription medication. But two potential barriers may be preventing people from seeking care: lack of affordability (52 per cent) and difficulty in accessing a provider (42 per cent). Other barriers include a belief that the individual can deal with their condition on their own (28 per cent); shame or embarrassment (27 per cent); or not thinking treatment would help (24 per cent).

“Effectively meeting the behavioural health needs of Americans and their families throughout the different stages of life requires providers, caregivers, policymakers, payers, and patients themselves to work together to reduce barriers to care,” said Lash. “There are still sizable numbers of people not getting the treatment they need – a situation that may only worsen as the population ages. Effective approaches, including integrated and person-centred models of behavioural health that deliver services through clinics or community-based organisations, should be more fully leveraged to ensure people are able to get the care they need when and where they need it.”

Since 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) has called for health plans to cover mental health benefits to the same level they cover general healthcare. According to the White House, however, “too many Americans still struggle to find and afford the care they need”. In 2020, the US Government reported less than half of those with a mental illness received care for it.

Last year, the Biden administration highlighted mental health as a priority with a “comprehensive national strategy to transform how mental health is understood, accessed, treated, and integrated in and out of healthcare settings,” which includes expanding access to mental health services from Medicare.