48% of Young Adults Struggled with Mental Health in Mid-2021

UCSF Study Shows Barriers to Care Persist

By Jess Berthold

Pensive young woman sitting on couch at home looking in the distance while thinking

About half of young adults had mental health symptoms during the pandemic and more than a third of those were unable to access mental health therapy, a new UC San Francisco study found.

The study, published April 11 in the Journal of Adolescent Health, used Household Pulse Survey (HPS) data from the U.S. Census Bureau to determine the prevalence of anxiety and/or depression symptoms in a sample of 2,809 adults ages 18-25 years. The data, collected in June through early July 2021, also included rates of mental health service utilization and unmet need for mental health therapy.

Forty-eight percent of young adults reported mental health symptoms and, among those with symptoms, 39% used prescription medications and/or received counseling, while 36% reported unmet counseling need. Female, Hispanic and uninsured young adults had the greatest unmet need, though these trends were not statistically significant.

The “unmet need” figures were a bit surprising, said Sally Adams, PhD, RN, specialist in UCSF’s Division of Adolescent and Young Adult Medicine.

Despite the development of virtual platforms for providing mental health services, the current need for services far exceeds the capacity to provide them.

Charles Irwin Jr., MD

“Given that only about one third of those with symptoms received care, we might have expected to see closer to two-thirds reporting unmet need,” said Adams. “It could be that the people with symptoms who didn’t report unmet need either didn’t think their symptoms were serious enough for treatment or feared the stigma of needing mental health services.”

While the rates of mental health symptoms in this study are high, they are a decline from a CDC study that found 63% of young adults were experiencing depression or anxiety a year earlier in June 2020.

Nonetheless, the consistent findings of significant mental health struggles among young adults highlight the importance of addressing barriers to care for this group, such as cost, stigma and confidentiality concerns, the authors wrote.

There is also a need to improve the size, distribution, and capacity of the mental health workforce, noted Charles Irwin Jr., MD, UCSF professor of pediatrics.

“Despite the development of virtual platforms for providing mental health services, the current need for services far exceeds the capacity to provide them,” he said.

Identification and treatment of mental health symptoms are crucial for promoting young adults’ present and future well-being across the life course, wrote the authors.

Authors: Study co-authors include Jason Schaub, MPH, M. Jane Park, MPH, and Claire Brindis, DrPH, who are all affiliated with UCSF’s National Adolescent and Young Adult Health Information Center; and Jason Nagata, MD, an assistant professor in UCSF’s Department of Pediatrics.

Funding: This study was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) (under #U45MC27709, Adolescent and Young Adult Health Capacity Building Program), with supplemental support from HRSA grants #UA6MC27378 and T71MC0003, and the American Heart Association Career Development Award (CDA34760281).