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Second Year of Pandemic Took a Heavy Mental Health Toll on Young Adults

Nearly half of 18- to 25-year-olds experienced any mental illness or a substance use disorder in 2021, according to the National Survey on Drug Use and Health’s latest report.

While the national rate of mental illness was 22.8% for adults overall in the second year of the pandemic, that proportion reached 33% among young adults, according to a survey by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration.

In the administration’s report released earlier this week, young adults also had the highest rates of “serious” mental illness: 11.4% in 2021 compared with 7.1% of adults ages 26 to 49 and 2.5% of those 50 and older. But juxtaposing this, the young adult age group had the lowest rate of mental health treatment.

“Every year since 1971, this survey has given us a window into our nation’s mental health and substance use challenges and 2021 was no different. As the findings make clear, millions of Americans young and old faced mental health and substance use challenges — sometimes both at once — during the second year of the pandemic,” commented HHS Secretary Xavier Becerra in a statement.

Both adolescents and adults pinned some blame on the COVID-19 pandemic for negatively impacting their mental health. Almost half of adolescents who experienced a major depressive episode and half of adults with a serious mental illness said the pandemic negatively affected their mental health “quite a bit or a lot.”

Mental illness afflicted about 28% of those between the ages of 26 to 49 and only 15% of those ages 50 and older in 2021.

Among all adults, a total of 12.3 million said they had serious thoughts of suicide in 2021, around 3.5 million said they made a suicide plan, and 1.7 million attempted suicide. Hispanic and Latino adults were the most likely to report this.

Racial disparities were also apparent in who received mental health services, as white and multiracial adults were more likely to receive treatment than Black, Hispanic or Latino, and Asian adults.

Shifting gears to adolescents, 20% experienced a major depressive episode in 2021, most of whom experienced severe impairment due to it.

There was a large amount of overlap with substance use disorder co-occurring with mental illness, the report indicated. About 14% of young adults battled both mental illness and substance use disorder that year. Multiracial adults represented the largest proportion of those meeting the criteria for both a mental illness and substance use disorder, while Asian adults had the lowest proportion.

Substance use and depressive episodes also appeared closely linked for teens, as significantly more who used illicit drugs experienced an episode versus those who didn’t (27.7% vs 10.7%).

Over a fifth of people ages 12 and older — some 52.5 million people — used an illicit drug in 2021, most commonly marijuana, according to the report. Roughly a third of young adults ages 18 to 25 used marijuana, while almost 40% of this age group said they used any illicit drug that year.

Out of the 61.2 million people ages 12 and older surveyed, 9.2 million said they misused opioids in 2021.

Taking that one step further, 16.5% of the population, representing 46.3 million people in the U.S., met the DSM-5 criteria for a substance use disorder diagnosis in 2021. While nearly 30 million people met the criteria for alcohol use disorder, there were also 24 million that were classified as having drug use disorder.

Alarmingly, 94% of individuals meeting the criteria for substance use disorder failed to receive any sort of treatment in 2021. This was driven by the fact that almost all expressed feeling no need for treatment. Another 2.1% said they felt they needed treatment but didn’t seek it out, and only 1.1% — representing 447,000 out of 40.7 million people — acknowledged they needed treatment and sought it out.

On the other hand, 72% of adults who self-reported having ever had a substance use problem considered themselves to be recovering or in recovery. Likewise, two-thirds of adults who said they faced a mental health issue also said they’re recovering.

“As we work to improve behavioral health across the nation, HHS is committed to ensuring that all people facing mental health or substance use challenges are connected to appropriate services and supports,” Becerra added.

  • Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

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