Changes in Mental Health and Treatment, 1997–2017

Abstract

Mental health outcomes have shown dramatic changes over the past half-century, yet these trends are still underexplored. I utilize an age-period-cohort analysis of the National Health Interview Survey from 1997 to 2017 (N = 627,058) to disentangle trends in mental health outcomes in the United States over time. Specifically, I leverage the contrast between reported psychological distress and rates of mental health treatment to isolate which has changed, how, and for whom. There is little evidence that psychological distress is worsening over time. Yet, treatment seeking has increased over the past 20 years. The increase in treatment seeking is best modeled as a period effect, providing initial evidence that the historical context has influenced responses to mental health over time for Americans of all ages and birth cohorts. I conclude with potential mechanisms and implications for future mental health research.