What Demographics Are Most at Risk of Having a Mental Illness?

The World Health Organization (WHO) notes that there are several kinds of mental disorders, comprising a wide range of symptom and behavioral effects.1 However, in general, a mental illness involves changes to brain structure or chemistry that lead to a different perception of reality, abnormal thoughts, emotional disturbances, and unusual behaviors. The federal government’s mental health website found that, in 2014:2

• One in five American adults reported a mental health issue.
• One in 10 adolescents experienced major depression.
• One in 25 Americans had a serious, chronic mental illness, which includes schizophrenia, major depression, and bipolar disorder.

Suicide, a risk that is increased by struggling with mental illness, was the 10th leading cause of death in the US.

The Demographics of Mental Illness

About half of all mental illnesses appear before the age of 14, and 75 percent develop by age 24. The current understanding of mental illness among medical professionals is that a complex combination of genetics, environment, and family history can put a person at greater risk for a mental illness.3 For example, if a parent had a substance use disorder, their children are at greater risk for developing mental illnesses due to that experience. People who have some kinds of mental illness in their family are more at risk for developing those specific mental illnesses.

Something in one’s environment, like a toxic chemical or life-threatening experience, can trigger a mental illness. Certain mental illnesses are more likely to be diagnosed in men while others are more likely to occur in women. Some are more likely to be noticed in children or adolescents while others do not appear until adulthood.

The National Institute on Mental Health (NIMH) found that, generally, more men than women report any mental illness: 21.2 percent of men compared to 14.8 percent of women report mental illness in general.4 However, certain conditions, like mood disorders, are more likely to affect women than men. This could be a disparity in professionals’ diagnoses, who is culturally associated with what condition, and who seeks treatment for their health. The disparity could also be due to genetic and environmental factors.

Young people transitioning from adolescence to adulthood are the most at risk for substance abuse, which affects their long-term mental health. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported the following figures in 2014:5

• 5 percent: people ages 18-25 who engaged in binge drinking
• 3 percent: people ages 21-25 who struggled with binge drinking
• 4 percent: adolescents ages 12-17 who had a major depressive episode
• 9 percent: adolescents who were diagnosed with a mental illness while 18.7 percent reported having a mental illness
• 4 percent: adolescents who had both a substance use and mental health disorder

In addition, SAMHSA found that suicide was the third leading cause of death among people ages 10-24 in 2014.6

Students between the ages of 14 and 21 with any mental illness are 37 percent more likely to drop out of school than their counterparts. Suicide from untreated mental illness is the third leading cause of death among children ages 10-14, and the second leading cause of death among adolescents and young adults between the ages of 15 and 24.

Age and gender are not the only demographics affected by mental illness. By race and ethnicity, self-identified white non-Hispanic people are more likely to use mental health services, but this could be an access issue.7

• Among American Indian/Alaskan Native adults, 28.3 percent have a mental illness.
• Among Caucasian individuals, 19.3 percent have any mental illness.
• Among black/African American adults, 18.6 percent have a mental illness.
• Among Hispanic adults, 16.3 percent have any mental illness.
• Among Asian adults, 13.9 percent have any mental illness.

People who identify as LGBTQA are twice as likely as heterosexual or cisgendered people to struggle with mental illness; 11 percent of transgendered people reported being denied mental healthcare due to discrimination.

Mood disorders – anxiety, depression, dysthymic disorder, and bipolar disorder, among others – are the most common forms of mental illness. Among those ages 18-44, the third most-common reason for hospitalization is an untreated mood disorder.

Chronic health disorders from substance abuse to obesity to cancer stem from mental health conditions, especially when they remain untreated. Adults with a serious mental illness die 25 years earlier, on average, due to treatable medical conditions.8

The Link between Substance Abuse and Mental Illness

Substance abuse and mental illness are closely tied together.9 NAMI reports that 10.2 million people have both a mental illness and a substance use disorder.10 One may trigger the other; for example, people struggling with bipolar disorder may develop an alcohol use disorder because they try to moderate manic symptoms. However, some substance abuse can trigger mental illness; stimulant abuse, like crystal meth addiction, can trigger a psychotic disorder.

About 18 percent of Americans experience mental illness, while 8 percent experience a substance use disorder. Of these, according to SAMHSA, 7.9 million people had both a substance abuse disorder and mental illness in 2014. This condition is called co-occurring disorders.11 People between the ages of 26 and 49 were the most affected by co-occurring disorders.

Getting Help to More People in Crisis

Statistics vary year to year about how many people get the help they need, but in general, around half the population struggling with a serious mental illness does not get the help they need.12 Mental Health American (MHA) found that about 56 percent of American adults did not get mental healthcare because of lack of access.13 Even in Vermont, which was reported to have the best access to high-quality mental and behavioral treatment, 46 percent of adults in the state did not get the care they needed due to lack of access. In states with the lowest workforce, MHA reports, there is only one mental or behavioral health professional per 1,000 residents. Many people with mental or behavioral conditions end up in prison, especially in areas with less access to care. Alabama, Arkansas, and Mississippi have incarcerated 57,000 people because of problems stemming from mental illness.

MHA found that 17 percent of adults with any mental illness remain uninsured as of 2017.13 This is improving, thanks to a greater national focus on healthcare. In 2011, 19 percent of adults with mental illness were uninsured; however, even with greater access to insurance, treatment remains elusive for too many. Over 56 percent of adults with mental illness received no treatment in the past year, and over 20 percent report continued lack of treatment for their needs.

In 84 percent of cases of onset of mental illness, the time between first symptoms and initiation of treatment is widened because the individual, their care providers, and their friends and family fail to recognize the symptoms of mental illness. For many, this time gap can lead to comorbid substance abuse, as the person tries to stabilize their brain chemistry.

Treatment and Prevention of Mental Illness

MHA maintains a page of resources for treatment for mental and behavioral conditions, including a list of symptoms to look for in loved ones who may develop a mental illness.

Making screening for mental illness and substance abuse a routine part of general healthcare, like the annual physical exam, can help to reduce the severity of these conditions when they begin. Campaigns to eliminate the stigma of both conditions, so people will get help when they recognize warning signs, are also helpful. However, if a person is predisposed to develop a mental illness or substance use disorder, and something triggers this condition, the focus must shift to treatment rather than prevention.3 Treatment ensures the illness does not become life-threatening, life-limiting, or tough to control.

There is no such thing as one simple solution for all mental illnesses or substance use disorders. While there are standards of treatment, specific forms of therapy and types of medication are needed, depending on the diagnosis and any co-occurring or comorbid conditions. However, an approach involving evidence-based counseling, therapy, prescription medications, and support from family and friends helps most people manage symptoms and lead healthy lives. As the link between mental health and substance use disorders is becoming better understood, drug rehabilitation programs are implementing better mental healthcare, so people with co-occurring disorders can get the best possible treatment.