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Young adults were most likely to report unmet mental health needs, substance use disorder and illicit drug use.
Frequent Mental Distress Rates and Depression Diagnoses Increased for Young Adults
The prevalence of frequent mental distress — the percentage of adults who reported their mental health was not good 14 or more days in the past 30 days — rose 24.8% from 11.7% to 14.6% between 2011 and 2021. For young adults (ages 18-25), frequent mental distress rose 101.7% from 12.1% to 24.4% between 2011 and 2021. Over the time points included in this analysis, young adults also experienced an 88.5% increase in a diagnosis of depression during their lifetime from 18.0% to 27.9%.
Mental and Behavioral Health Challenges Decreased With Age
Young adults and those ages 26-34 experienced multiple disparities in mental health outcome measures compared to older adult age groups. In 2021, rates of frequent mental distress were 2.3 times higher for young adults (24.4%), 1.8 times higher for adults ages 26-34 (19.1%) and 1.5 times higher for adults ages 35-49 (15.3%) compared to older adults ages 50+ (10.5%). Similarly, disparities for diagnosed depression decreased with age. In 2021, rates of diagnosed depression were 1.7 times higher for young adults (27.9%), and 1.5 times higher for adults ages 26-34 (24.6%) compared to older adults ages 50+ (16.9%).
Young Adults Had the Widest Disparities for Suicidal Thoughts, Depressive Symptoms and Unmet Mental Health Treatment Needs
In 2021, young adults had the widest disparity ratios compared to older adults (50+) for suicidal thoughts (6.4 times higher) and having experienced symptoms of a major depressive episode (4.0 times higher rate). At the same time, young adults were 3.2 times more likely to report having an unmet mental health treatment need in the past year. Young adults also experienced wide disparities for frequent mental distress, substance use disorder and diagnosed depression. Factors such as social disconnection and societal trends may put some demographic groups, including young adults, at higher risk for loneliness, isolation, anxiety, depression and poor health.9-13
Adults Ages 26-34 Experienced Higher Rates of Co-occurring Mental Illness and Substance Use Disorder
Adults ages 26-34 had the highest rates of illicit drug use, as well as co-occurring low-to-moderate mental illness and substance use disorder (LMMI SUD) compared to other adult age groups. The rate of co-occurring LMMI and SUD for adults ages 26-34 was 3.2 times higher compared to older adults ages 50+ (2.9%) in 2021. Adults ages 26-34 experienced a 39.8% increase in diagnosed depression and 44.7% increase in frequent mental distress between 2011 and 2021.
Children living below the federal poverty level were more likely to have risks to household support, safety and well-being.
Recent national estimates highlighted in previous America’s Health Rankings reports indicate that 9.9 million children have experienced two or more of nine adverse childhood experiences (ACEs). ACEs can include various traumatic events during childhood, such as witnessing or being a victim of violence, physical or emotional abuse, neglect, household dysfunction or parental separation or divorce. Having two or more household-level ACEs is considered a health risk that influences youth safety, stability and support in their home.7
This analysis found that in 2021, children living below the federal poverty level were 2.7 times more likely to have experienced two or more of six household- level ACEs compared to households at or above 400% of the federal poverty level (16.9% compared to 6.2%).