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SAMHSA Report Reveals Americans’ Mental Health and Substance Use Struggles

The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its annual National Survey on Drug Use and Health. The survey asks Americans about their experiences with mental health conditions, substance use and pursuit of treatment. The report further confirmed mental health and substance crises in America, and that most are not receiving treatment for their conditions.

Consider the following key findings from the 2021 SAMHSA report:

Drug Use and Substance Use Disorder (SUD)

  • 46.3 million people aged 12 or older (16.5% of the population) met the criteria for having a SUD.
  • SUDs were highest among young adults ages 18 to 25 compared to youth and adults 26 and older.
  • 94% of people aged 12 or older with a SUD didn’t receive treatment.

Mental Health

  • Nearly 1 in 4 adults aged 18 and older, and 1 in 3 among adults aged 18 to 25, had a mental illness.
  • 1 in 5 adolescents had a major depressive episode.


  • 12.3 million adults aged 18 and older had serious thoughts of suicide, with 3.5 million making suicide plans and 1.7 million attempting suicide.

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. Millions of Americans faced mental health and substance use challenges—sometimes both at once—during the second year of the pandemic.

- HHS Secretary Xavier Becerra

Getting Help Today

The pandemic significantly impacted Americans’ mental health and substance use—and challenges are likely to continue as the country also navigates economic uncertainty.

Most Americans are unaware of the new 988 National Suicide Prevention Lifeline (Lifeline). Similar to how 911 is used, the 988 dialing code is for anyone experiencing mental health-related distress, including thoughts of suicide, mental health or substance use crisis, or other emotional struggles. People can also call the Lifeline if they’re worried about a loved one needing emergency support. Additionally, individuals can always reach out to a doctor or mental health professional if they have concerns.