Number and percentage of population with expenditures for the treatment of mental disorders by selected demographic characteristics (figures 1 and 2)

In 2019, an estimated 17.3 percent (43.9 million individuals) of adults age 18 and older in the U.S. civilian noninstitutionalized population had some healthcare expenditures for the treatment of mental disorders (figure 1). The number of females with expenses for the treatment for mental disorders was almost double that of males (29.1 million versus 14.8 million). Almost 20 (19.8) percent, or one in every five adults who were ages 65 and older, had expenditures for mental disorders in 2019. This was higher than the percentage of adults ages 18–64 (16.6 percent).

Figure 1

Number and percentage of adults ages 18 and older with treatment for mental disorders, by age and sex, 2019.

Approximately one in every five non-Hispanic White adults (21.7 percent) had expenditures for the treatment of mental disorders in 2019 (figure 2). This was more than double the percentages of non-Hispanic Black adults (10.1 percent) and Hispanic adults (9.7 percent) who had any expenditures for the treatment of mental disorders.

Figure 2

Percentage of population with treatment for mental disorders among adults ages 18 and older, by race/ethnicity, 2019.

Total expenditures for the treatment of mental disorders, by age and sex (figure 3)

A total of $106.5 billion in expenditures was reported for the treatment of mental disorders among adults 18 and older in 2019 (figure 3). A major share of these expenditures, $88.4 billion, was spent on care for adults between the ages of 18 and 64, while only $18.1 billion was spent on treatment for adults ages 65 and older.

Figure 3

Total expenditures for treatment of mental disorders among adults ages 18 and older, by age and sex, 2019.

Expenditures were higher for treatment of mental disorders for females than for males ($61.5 billion versus $45.0 billion).

Percentage distribution of expenditures for the treatment of mental disorders by type of service (figure 4)

Among all adults with any expense for the treatment of mental disorders, the highest proportion (41.5 percent) was spent on ambulatory visits (figure 4). This was followed by about 30 percent (29.8 percent) spent for prescription drugs. Expenditures for all other types of services (emergency room, hospital stays, and home health) comprised the remainder (28.7 percent) of the total expenditures for the treatment of mental disorders among adults in 2019.

Figure 4

Percentage distribution of expenditures for treatment of mental disorders among adults ages 18 and older, by type of service, 2019.

Percentage distribution of expenditures for the treatment of mental disorders by source of payment (figure 5)

In 2019, a total of $33.9 billion, or about one-third (31.8 percent) of expenditures for the treatment of mental disorders, was paid by private insurance (figure 5). The second biggest payer was Medicaid, with expenditures of $27.6 billion, or a little over one-fourth (25.9 percent) of the total spent for the treatment of mental disorders among adults ages 18 and older. Almost one-fifth (19.1 percent) of mental disorder treatment expenditures were paid by Medicare, which paid a total of $20.4 billion, followed by $15.6 billion (14.7 percent) paid by individuals and families out of pocket.

Figure 5

Percentage distribution of expenditures for treatment of mental disorders among adults ages 18 and older, by source of payment, 2019.

Mental disorders

This Brief analyzes adults ages 18 and older with a mental disorder as reported in connection with healthcare utilization. The conditions reported by respondents were coded by professional coders to fully specified International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Conditions with Clinical Classifications Software Refined (CCSR) codes MBD000–MBD034 (including mental, behavioral, and neurodevelopmental disorders as well as opioid-, alcohol-, and substance abuse-related conditions) were used in this Brief.

Expenditures

Total expenditures are defined as payments from all sources (see definitions below) for hospital inpatient care, ambulatory care provided in offices and hospital outpatient departments, care provided in emergency departments, home healthcare, and prescribed medicine purchases reported by respondents in the MEPS-HC. Payments for other medical expenses, such as durable and nondurable supplies, medical equipment, eyeglasses, ambulance services, as well as for dental expenses are excluded.

Age

Age was defined as age at the end of calendar year 2019 (or on the last date of MEPS eligibility if the person was out of scope at the end of the year).

Ambulatory

Office-based and outpatient visits were called Ambulatory visits.

Race/ethnicity

MEPS respondents were asked if each family member was Hispanic or Latino and about each family member’s race. Based on this information, categories of race and Hispanic origin were constructed as follows: Hispanic; White, non-Hispanic (no other races reported); Black, non-Hispanic (no other races reported); and other/multiple races, non-Hispanic.

Sources of payment

Sources of payment are classified in following categories in this Brief:

• Out of pocket (e.g., direct payments from individuals and families).
• Private insurance: Payments made by private insurance plans covering hospital and other medical care services (excluding payments from Medicare, Medicaid, and other public sources). Payments from TRICARE (Armed Forces-related coverage) are included in this category.
• Medicare: Payments by Medicare, which is a federally financed health insurance plan for persons aged 65 and older, persons receiving Social Security Disability payments, and persons with end-stage renal disease.
• Medicaid: Payments by Medicaid and the Children’s Health Insurance Program (CHIP), which are means-tested government programs jointly financed by federal and state funds that provide healthcare to those who are eligible.
• Other sources: Includes payments from the U.S. Department of Veterans Affairs (except TRICARE); other federal sources (Indian Health Service, military treatment facilities, and other care provided by the federal government); various state and local sources (community and neighborhood clinics, state and local health departments, and state programs other than Medicaid/CHIP); workers’ compensation; and various unclassified sources (e.g., automobile, homeowner’s, or other liability insurance, and other miscellaneous or unknown sources).

Soni, A. Health Care Expenditures for Treatment of Mental Disorders: Estimates for Adults Ages 18 and Older, U.S. Civilian Noninstitutionalized Population, 2019. Statistical Brief #539. February 2022. Agency for Healthcare Research and Quality, Rockville, MD. https://meps.ahrq.gov/data_files/publications/st539/stat539.pdf

AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please email us at vog.shh.qrha@rotceriDtcejorPSPEM or send a letter to the address below: