Washington: The number of Americans receiving mental health treatment has surged, yet experts have cautioned lawmakers that outcomes are worsening, raising concerns about overdiagnosis, misaligned incentives, and the growing mental health crisis in the United States.

At a Congressional roundtable on mental health policy, legislators and experts described a system that is expanding rapidly in both reach and cost, but struggling to deliver measurable improvements in mental well-being.

Mental health treatment in the US doubles, but depression and suicide rates climb

Congressman Glenn Grothman highlighted that the number of adults receiving mental health care has more than doubled over the past two decades, rising from 27 million in 2002 to roughly 60 million in 2024. Yet, depression rates remain at historic highs, while suicide rates have returned to “their highest levels in decades.”

“hat raises a fundamental question,” Grothman said. “If we are treating more people than ever before, why are we not seeing better results?”

David Hyman, a health law professor, pointed to structural flaws in the system. Spending on mental health and substance use disorders has grown faster than overall healthcare expenditure, now accounting for roughly 5 per cent of total US healthcare spending. Yet, higher spending does not automatically translate into better mental health outcomes.

“When we pay for services, we get services; we don’t necessarily get better mental health,” Hyman said, citing “misaligned incentives” and the lack of reliable measures of effectiveness. He also noted ongoing fraud concerns, describing mental health as a “fraud-laced industry” where billing for services not performed and falsified records remain prevalent.

Also Read| Abdominal fat a bigger health risk than overall obesity: Jitendra Singh

Overdiagnosis and early medication raise concerns

Psychiatrist Sally Satel warned lawmakers that overdiagnosis and the medicalisation of everyday stress are contributing to poor outcomes.

“Clinicians are overdiagnosing too many people who do not have a psychiatric condition,” she said, while acknowledging that some mental health conditions are genuinely increasing.

She highlighted a sharp rise in child diagnoses. In 2023, one in 36 children was identified with autism, up from one in 110 in 2006. Around 10 per cent of young people are diagnosed with attention deficit hyperactivity disorder (ADHD), often with minimal evaluation and an early reliance on medication. Behavioural therapies are frequently bypassed, despite evidence of their effectiveness.

Satel also criticised disability programmes for mental health conditions, noting that many patients are removed from the workforce without reassessment. “Work is one of the best therapies there is,” she said.

Also Read| Want better immunity? NITI Aayog flags gut health risks amid diet shift in India

Patient experiences reveal long-term challenges

Laura Delano, founder of the Inner Compass Initiative and a former patient, described the consequences of long-term psychiatric treatment. Millions of Americans are prescribed psychiatric medications without clear guidance on long-term risks or safe discontinuation.

“Nearly a million people have accessed our resources,” Delano said, highlighting struggles with withdrawal and overmedicalisation. “What we are calling a mental health crisis is, in large part, a crisis of overmedicalisation,” she added, describing a system that reduces complex human struggles to pharmaceutical solutions.

Rising mental health challenges prompt urgent review

The rise in suicide rates and reported mental health challenges, particularly among young Americans, has intensified scrutiny of how mental health care is delivered. Experts emphasise the need for approaches that address underlying social, behavioural, and economic factors driving distress, rather than relying solely on medication.

IANS