The State of Mental Health in the U.S.: Progress, Pitfalls, and What’s Next

Mental health has finally made it into the national conversation. Over the last five years, the mental health industry in the U.S. has undergone massive shifts—some long overdue, some growing pains, and some still stuck in neutral. From the rise of teletherapy to increased public awareness, there’s been real progress. But we’re still facing major gaps, especially around access, equity, and quality of care.

What’s Changed in the Last Five Years?

1. Mental Health Went Mainstream

Stigma didn’t vanish, but it lost ground. Celebrities, athletes, and influencers spoke openly about their struggles. Mental health became a workplace issue, not just a personal one. Talking to a therapist went from “Are you okay?” to “Good for you.”

2. The Pandemic Forced a Reckoning

COVID-19 was a mental health pressure cooker. Isolation, anxiety, job loss—it hit everyone, hard. This sparked a surge in demand for mental health services and highlighted just how underprepared the system was. It also made people more aware of their mental well-being—and more willing to seek help.

3. Telehealth Exploded

Therapy via video call went from fringe to normal. Platforms like BetterHelp and Talkspace boomed. Insurance companies started covering virtual visits. Suddenly, therapy could happen from your bedroom instead of an office across town. This made care more accessible for many—but not all.

4. Younger Generations Led the Charge

Gen Z has been the most open and proactive generation yet about mental health. They expect mental health support in schools, at work, and in their digital spaces. They’ve pushed for mental health days, better counseling services, and more inclusive care.

5. More Focus on Equity, But Still a Long Way to Go

The racial justice movement of 2020 forced a closer look at disparities in mental health care. Black, Indigenous, and people of color (BIPOC) still face barriers—lack of culturally competent providers, financial hurdles, and systemic distrust. The conversation is happening, but the gap is far from closed.

What’s Still Broken?

Access Is a Disaster

Even with more therapists and online platforms, waitlists are months long in many areas. Rural communities are especially underserved. And good luck finding a provider who takes your insurance—or any insurance at all.

The System Is Fragmented

Mental health care often operates separately from primary care, which leads to poor coordination. You can get prescribed antidepressants from your primary care in 10 minutes, but finding a therapist to actually work through your issues? That’s on you.

Workplace Mental Health Is Still Performative

Many companies added wellness apps or mental health days, but few addressed root causes like burnout, toxic management, or lack of support. Employees want more than lip service—they want change.

Quality Varies Wildly

There’s no consistent standard for therapy quality, and outcomes can be hit or miss. Some online platforms prioritize volume over care. Others rely on unregulated “coaches” instead of licensed therapists.

What Needs to Happen Next?

1. Normalize Regular Mental Health Checkups

We do annual physicals—why not annual mental health check-ins? Catch issues early, treat them before they spiral. Make it standard care, not crisis response.

2. Make Mental Health Care Affordable

Insurance coverage for therapy needs to be stronger and simpler. Employers can help by offering comprehensive mental health benefits that aren’t just apps and hotlines.

3. Build a More Diverse Provider Pool

More therapists of color. More LGBTQ+ providers. More people who understand trauma, disability, cultural nuances, and systemic oppression. Representation matters in healing.

4. Integrate Mental and Physical Health

Mental health shouldn’t be siloed. Combine it with primary care. Make sure doctors ask about your mental well-being and can actually refer you to real help.

5. Invest in Prevention, Not Just Treatment

Stress management, emotional education, resilience-building—these need to start in schools and continue in communities. Don’t just treat problems. Teach people how to stay mentally well.

Bottom Line

The mental health industry has come a long way—but it’s still playing catch-up. Demand is high, the conversation is open, but the infrastructure is weak. We need systems that match the moment: accessible, affordable, inclusive, and proactive. Because mental health isn't a trend. It’s part of being human—and it’s time our care systems started acting like it.

If you or someone you know is struggling with thoughts of suicide, call 988.