The Mounting Mental Health Crisis in the US
The mental health care crisis in the United States has been the topic of headlines for decades. Despite efforts by Federal and State governments, this crisis persists. The response has generally been to (a) increase awareness, (b) conduct screenings, and (c) implement intensive treatment through policy, funding, and initiatives. While these efforts are helpful and evidence based, our country is witnessing a growing problem.
In 2024, nearly 1 in 10 adults reported experiencing a mental health crisis, defined as an acute episode where one feels unable to function and needs immediate help. Prevalence of such episodes was the highest among young adults and minorities (Anderson et al., 2025). Mental health crises are closely linked to substance abuse, drug overdose, and suicide, which continue to be leading causes of death in the United States (Center for Disease Control and Prevention, 2025). This issue, undoubtedly made worse by social factors, the pandemic, and world events, is difficult to address comprehensively (FAIR Health, 2024).
For the year 2026, The Substance Abuse and Mental Health Services Administration (SAMHSA) authorized $7.4 billion in Federal funding from the Consolidated Appropriations Act (“Consolidated Appropriations Act”, 2026; Health and Human Services, 2026). The bulk of the funding is aimed at reducing acute and severe mental health conditions, specifically substance abuse (56.7%, or $4.2 billion), that can require intensive outpatient programs (IOPs) or partial hospitalization programs (PHPs). Notably, of this huge sum, only 6.8%, or 503.2 million, is focused on prevention and screening (SAMHSA, 2024).
Economic and Social Impact
In practical terms, the financial impact of the mental health crisis is more than the Federal funds allocated to address this issue. Columbia Business School estimates that the cost of mental health issues reaches approximately $282 billion in the US each year due to the expense of services and the trickle-down effects on economic behavior (Sperling, 2024). According to researchers, more than 20% of the US population currently has a mental illness and more than 5% has a severe mental illness. The socioeconomic effect is amplified when people experiencing even mild mental health issues feel less willing to take on challenges, new responsibilities, or a calculated risk. A person struggling with a depressive, negative outlook on the future may be unlikely to make sound long-term investments (e.g., stocks and real estate). Identifying conditions that are comorbid with substance abuse and treating them prior to the manifestation of a crisis would be a preferable strategy for addressing this problem. The downstream effect would be happier, engaged workers, contributing to a stronger economy.
Therapists can bridge the gap between mental health screening and intensive treatment programs, working towards more positive outcomes. With proper support and access, a person could receive help from a professional and mitigate the worst symptoms of their mental health before resorting to “self-medication” in alcohol or narcotics. If an oncologist told their patient to wait until stage 4 to undergo cancer treatment, the patient would be looking for a different doctor. So, why don’t we have the same approach for mental health?
History of Preventive Medicine
In 1736 Benjamin Franklin famously wrote that, “An ounce of prevention is worth a pound of cure.”
Ever wonder how semi-annual dental visits became common practice? The annual physical? Routine screening procedures like colonoscopies, mammograms, pap smears, and prostate exams? If we are to distinguish “physical health care” and “mental health care,” who determines what constitutes preventive physical health care?
Twice annual dental visits were originally popularized in the early 20th century through advertising of oral care products (Spielman, 2024). Surprisingly, there is minimal evidence supporting a visit to the dentist every 6 months, and no corresponding randomized controlled trials (RCT) which are the gold-standard of evidence-based medicine (Najith Amarasena, 2023). In the 1950s the demands of labor unions, coupled with what people considered “common sense prevention” led to dental insurance coverage for biannual dental visits, and the practice we now take for granted was born (Delta Dental, n.d.). Insurance companies implemented coverage for the biannual dental visit prematurely, without adequate supporting data. However, research over the last 75 years shows that oral health has improved in many areas and the biannual dental visit continues to be an entrenched feature of the healthcare landscape in the United States (NIH, 2021). While the origins of preventive dental care were not founded in data, positive patient outcomes (and the supporting data) followed the implementation of the practice.
Another standard practice of preventive medicine, the yearly physical, became a topic in the US in the 1920s with strong support from the American Medical Association (AMA). The AMA presented the “physical” as a way to maintain health and detect illness early (Gorbenko et al., 2017). While the implementation of the annual physical seems like intuitive preventive medicine, this practice, like the biannual dental visit, lacks evidence that comprehensive examination or laboratory screening tests are indicated for healthy adults (Chacko, 2007; Krogsbøll, 2019). According to Krogsbøll’s 2019 review of 17 RCTs, general health checks oddly did not reduce morbidity or mortality and the yearly physical did not improve health in otherwise healthy adults. That said, beneficial outcomes are actually tied to lifestyle counseling, immunizations, and risk-based screenings, rather than to the yearly physical itself (Himmelstein & Phillips, 2016; Shein & Stone, 2017). It is also evident that primary care visits increased the use of evidence based preventive interventions (Hostetter et al., 2020). For example, in 2011, mental health screenings became a standard part of the yearly physical, with physicians attempting to meet the increasing need for mental health care (CMS, 2011).
In comparison, stronger evidence supports colonoscopies, mammograms, pap smears, and prostate screenings compared to the biannual dental visit and yearly physical (Bitler & Carpenter, 2016; Ilic et al., 2018; Zhang et al., 2020). At the time of standardization of these now routine cancer screenings, much of the data we have now had yet to be generated (Winstead, 2024). Researchers built our understanding of the utility of these practices either after their implementation or gradually with evidence building alongside their adoption as a standard of care.
Physicians and dentists have followed their intuition and common sense that prevention offsets potentially devastating consequences. It is time for mental health care to catch up and employ this same strategy.
Our Blueprint for Mental Wellness
Our team at The Perfect Therapy Group (PTG) believes preventive and personalized care are essential in maintaining and optimizing well-being.
In addition to traditional therapy, since spring 2025 we have been offering semi-annual Mental Wellness Visits (MWVs), which include two initial intake sessions where “vital signs” are assessed in areas such as anxiety, mood, relationships, life satisfaction, stress, sense of self, lifestyle factors, and sleep. Having this conversation about mental health vital signs is especially important, as clients increase their self-awareness and engage in routine self-monitoring.
PTG then provides tailored recommendations and a wellness plan based on the intake assessment to strengthen resilience. To continually monitor data points around anxiety, depression, stress, substance use, and flourishing, PTG administers the Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995), Alcohol Use Disorders Identification Test (AUDIT-C+3; Bush et al., 1998), and the Flourishing Scale (FS; Perera et al., 2018), respectively. Flourishing and life satisfaction, otherwise referred to as positive psychology, are particularly important domains for us to help clients reach their goals. It’s not enough to reduce symptoms of anxiety or depression. We want to see our clients thriving. The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Similarly, we want clients to experience a state of psychological well-being, not just an absence of mental health disorders.
For this reason, at PTG there is always the option for as-needed booster sessions scheduled at the client’s request. This allows clients to schedule regularly (to see us before they need us) with a practice that has a documented history, continuity of care, and an already established, trusted relationship with them.
Anecdotally, the response to MWVs has been overwhelmingly positive when considering providers’ observations and direct feedback. PTG clinicians have noticed clients reaching out more easily, and that the wellness visits have helped mitigate mental health concerns and maintain treatment progress. When existing clients learn of this offering, they are excited and appreciative of having this option. When the PTG team shares the idea of MWVs with other stakeholders such as medical providers, legislators, and community leaders, the response has often been, “That’s a great idea! Why aren’t we doing this already?”
Moving toward “Mentainable”
This author implores others to join her and the PTG team in promoting this biannual preventive strategy because one practice alone cannot make a broad change, or transform the standard of care in the field. The primary focus is to innovate approaches and implement system level changes that nurture psychological well-being in individuals over the long term. The mental wellness visits are just one facet of this effort. We hope this article is a catalyst for a societal overhaul which promotes a more “mentainable” (i.e. “mentally sustainable”) world.
To start with, we can tackle some low-hanging fruit in the following ways:
- Ask “Who’s your therapist?” Whether you are casually talking to a friend or filling out a medical intake form, this question should become more common. The more we talk about therapy, the more likely it will be for people to integrate MWVs in their routines.
- Make MWVs more widespread. Any mental health care provider can share and implement this idea. Check out how we do it here if you are interested in how PTG highlights this service.
- Lobby for insurance coverage for semi-annual MWVs for all Americans.
- Invest in research and data collection for preventive mental health care. We encourage professional organizations, such as the American Psychological Association and American Psychiatric Association, as well as State and Federal governing bodies, to devote human and financial resources to research preventive mental health care.
We encourage our readers to prioritize their psychological well-being as much as their physical health. After all, the mind and body are intertwined.
Self-Reflection
- Do you have a mental health care provider? If you have one, can you request MWV’s with them moving forward? If you do not have a mental health care provider, is there a trusted person you can ask for recommendations?
- Do you value your psychological well-being as much as your physical well-being? If one is valued more than the other, why? Do you want this to change?
- How can you initiate or contribute to a discussion about preventive mental health care in your field or industry?
- Consider your local environment, your social circles, your relationships, and your job. What would you consider a “mentainable” (mentally sustainable) world for you?
