Unmet Need for Mental Health Care is Common Across Insurance Market Segments in the US

Abstract A substantial proportion of individuals with depression in the United States do not receive treatment. While access challenges for mental health care have been documented, few recent estimates of unmet mental health needs across insurance market segments exist. Using nationally representative survey data with participant-reported depression symptom severity and mental health care use collected in Spring 2023, we assessed access to mental health care among individuals with similar levels of depression symptom severity with commercial, Medicare, Medicaid, and no insurance. Among individuals who reported symptoms consistent with moderately severe to severe depression, 37.8 percent did not have a diagnosis for depression (41.0, 28.1, 33.6, and 56.3 percent with commercial, Medicare, Medicaid, and no insurance), 51.9 percent did not see a mental health specialist (49.7, 51.7, 44.9, and 91.8 percent), and 32.4 percent avoided mental health care due to affordability in the past twelve months (30.2, 34.0, 21.1, and 54.8 percent). There was substantial unmet need for mental health treatment in all insurance market segments, but especially among individuals without insurance.