Here’s Why There’s a Lack of Mental Healthcare Services—and What It’s Doing to Patients

We’re living through a mental health crisis, but the workforce shortage makes it hard for everyone to get help. Read on to learn more.

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We are living in the midst of a mental health crisis — data shows over 1 billion people worldwide are living with a mental health condition — but access to mental healthcare remains limited. While mental health awareness has greatly increased over the past few years, access to mental health services hasn’t. In fact, there’s a lack of mental health services and a shortage of providers. 

So, even as more and more people recognize the importance of mental health, many are still unable to get the care they need. Read on to learn more about the lack of mental health services (particularly in the United States), the impacts of the lack of care, and what we can do to move the needle in the right direction.

Understanding the lack of mental health services in the United States

A large number of people in the U.S. are struggling with mental health. 23% (nearly 1 in 5) of U.S. adults have a mental health condition, and 6% (nearly 1 in 18) have a serious mental illness, such as major depressive disorder, bipolar disorder, or schizophrenia. 

Despite the fact that awareness of mental health has improved and stigma has decreased in recent years, there is a known workforce shortage of mental health professionals to keep up with the growing demand for care.

Why is there a lack of mental health services?

“There are too few providers to accommodate rising rates of anxiety, depression, substance use disorders, and so on,” says Mike Travisano, a Certified Mindfulness Instructor and Group Facilitator at Charlie Health. “And this is all happening in a healthcare system that is antiquated, costly, and fragmented.” 

Many people who need mental healthcare don’t receive it. Estimates show that 48% of U.S. adults with a mental health disorder did not receive the treatment they needed. 

One reason people might not be able to access care is a lack of services in their area. 137 million people– about 40% of the U.S. population live in a “mental health professional shortage area.” These are most likely in rural areas. In fact, 80% of rural counties don’t even have one psychiatrist. 

Regardless of location, another factor contributing to the shortage is an aging workforce, according to the American Counseling Association. They report that many mental healthcare providers are retiring or nearing retirement, but they aren’t being replaced by younger new professionals at the same rate.

The U.S. Health Resources and Services Administration projects “substantial shortages” of mental health professionals (including mental health counselors, addiction specialists, psychiatrists, and more) by 2038, based on future estimates of supply and demand.

As of now, there are about 1,058,049 mental health and behavioral healthcare providers, ranging from social workers to substance abuse counselors to psychiatrists. While this sounds like a lot, there are almost 60 million U.S. adults living with mental illness. When you look at it this way, it’s no wonder there’s a shortage of care and why some providers have long waitlists or no availability at all.

What is the impact of the lack of mental health services?

The lack of mental health services can have detrimental effects on the people of the country who are struggling with their mental health. “In short, they suffer,” Travisano says. “They either suffer more deeply, or more than they otherwise would have to.” 

Generally speaking, mental health conditions don’t just disappear on their own. In fact, they’re likely to get worse over time without treatment. Some of these people might just suffer alone, while others turn to ineffective or harmful “solutions,” Travisano says. For example, someone with depression who isn’t getting treatment might turn to alcohol to self-medicate, which can snowball into a full-blown alcohol use disorder.

Another ineffective “solution” people might turn to is AI, which can potentially be dangerous, Travisano says. Relying on AI for therapy is not safe, especially when you need help for a serious mental health concern. In the most severe cases, AI chatbots have been linked to suicides and even AI psychosis, when someone loses touch with reality due to excessive AI usage. 

Sure, in the future, there might be major developments for AI’s place in mental healthcare, such as guardrails to act as suicide prevention measures, but for now, AI is simply unreliable for mental healthcare. 

Lack of mental health services for veterans

While the shortage affects nearly everyone, some populations, such as veterans, have a higher risk of developing mental health conditions and accessing care. 

A Veterans Affairs (VA) report showed that nearly one-third (31%) of veterans who use VA healthcare have a mental health diagnosis, such as post-traumatic stress disorder (PTSD), anxiety, bipolar disorder, depression, or a substance use disorder. 

Many of these veterans could benefit from mental health support, but many don’t get the help they need, or don’t get as much help as they need. “Vets may receive monthly counseling follow-ups, but they rarely see the same provider or experience consistency,” says Brooke Cortez, MSW, MT-BC, NMT, a Creative Arts Therapist at Charlie Health. “For veterans with diagnoses like complex PTSD, a monthly check-in with a counselor is not enough.”

Not to mention, the VA has been employing fewer psychologists, and 57% of VA medical centers report a shortage of psychologists. To make matters worse, in 2025, the government cut 30,000 VA employees and put a cap on medical center staff — the opposite of what we need to help veterans who are struggling.

Lack of mental health services in schools

Additionally, a large number of children and teens struggle with mental health. The CDC reports that 21% of youth ages 3 to 17 have been diagnosed with a mental, emotional, or behavioral health condition. That’s nearly 1 in 5 children. The unfortunate reality is, schools aren’t equipped to handle this. Put simply, very few trained professionals are available to help students who need it, Travisano says.

“It is not a secret that rates of anxiety and depression have increased among young people, especially following the pandemic,” he adds. “These increases have not been met with a commensurate increase in qualified people to address these needs in schools, nor by increases in school budgets to hire those resources.”

The recommended ratio for students to school psychologists is 500 to 1 (which still seems pretty low), and the actual number for 2024-2025 was 1071 students to 1 school psychologist. There’s no denying that this isn’t nearly enough to give students the mental healthcare they need. 

“Many kids who could benefit from help don’t get it, or don’t get enough of it,” Travisano says. “This not only results in kids who are suffering, but their families, as well. This can also show itself in behavioral issues at schools as well as school performance problems.”

How can we get more people the help they need?

Changes to improve the lack of mental health services in the country won’t happen overnight. 

But how can we improve the workforce shortage? One idea Travisano proposes is providing incentives for people to enter and remain in the mental healthcare field, such as student loan deferments or forgiveness. Other incentives could be signing bonuses or tax credits.

Additionally, the National Conference of State Legislatures reports proposed legislation that could allow people with four-year degrees in related fields to become licensed behavioral health coaches and for psychologists to prescribe low-risk medications, along with special training. 

Addressing wage disparities could also help, since mental healthcare workers who practice in public health or community settings make less money than those in private practice or practicing in hospitals. 

Another major pain point is insurance reimbursement rates. Many providers report low rates when they accept insurance, which is why over one-third of psychologists choose not to take insurance, making care even more inaccessible for those who need it. Increasing reimbursement rates could be a way to combat this, the National Alliance on Mental Illness reports. 

In addition to addressing the workforce shortage, there are other ways that we can reduce additional barriers to care, including:

1. Raising awareness and reducing stigma

Society has definitely seen less stigma over recent years, but we still have a way to go. “Destigmatization of mental health diagnoses is also important so that individuals do not feel ashamed to seek services,” Cortez says. 

2. Fixing healthcare fragmentation

For many people, it isn’t as easy to access mental health services as it is to access primary care services. “Include mental health professionals in primary healthcare provider spaces, so they can get help where they’re already receiving care,” Travisano suggests.

3. Continuing to improve telehealth access

Expanding telehealth services can help bridge care gaps, especially for people in rural or other underserved areas. However, insurance will need to continue to cover telehealth appointments. Allowing for more cross-state licensing could also increase access. 

4. Reducing cost of care and insurance barriers

Many clinicians don’t take insurance, and even if they do, copays and deductibles can still make mental health services unaffordable, Travisano says. 

How Charlie Health can help 

Whether you live in a rural area or urban center, if you’re struggling with your mental health, Charlie Health is here to help. Charlie Health is a virtual behavioral health provider delivering high-acuity treatment for kids, teens, and adults facing serious mental health conditions and substance use disorders. Our innovative treatment model combines clinical expertise, group connection, and measurement-based care to support long-term healing. With the right support, managing your well-being is possible. Fill out the form below to start healing today.