Highlights
  • 85% of North Carolinians faced mental health challenges last year, with more than one-third (35%) dealing with consistent issues.
  • 36% of respondents reported mental health improvements, while 33% saw no change, and 28% experienced worsening mental health.
  • Personal finances and rising cost of living are the top stressors affecting North Carolinians mental health (44%), followed by relationships (33%), family dynamics (32%), and social media use (28%).
  • Half of North Carolinians (52%) plan to seek therapy in the next year. Those that won’t (48%) cite reasons like cost (30%) or a perceived lack of necessity (66%).

A recent survey of people in North Carolina commissioned by Thriveworks reveals interesting patterns surrounding residents’ emotional state and what they do to improve their mental health.

Check out the insights below, including which factors impact mental health most, who they turn to for support, and more.

North Carolina’s Mental Health Landscape

A large group of North Carolinians (85%) dealt with mental health issues at some point in the last year, with more than one-third (35%) of respondents saying they consistently struggled with mental health.

Despite these challenges, people in North Carolina saw some improvement: 36% of respondents report their mental health is better than it was one year ago. However another third of North Carolinians (33%) saw no change, and only slightly fewer people (28%) say their mental health has worsened.

36% of North Carolinians experienced improvement in their mental health in the last year, while 33% reported no change and 28% had their's worsen.

Mental Health Issues Impact North Carolinians’ Well-Being

Mental health impacts several areas of North Carolinians’ lives. More than half of respondents (53%) reported sleep habits were affected, while another large group (47%) said mental health issues negatively impact their overall health and wellness.

Poor mental health also reportedly inhibited people’s ability to function and manage their daily lives, impacting their ability to:

  • Find or keep employment (33%)
  • Foster healthy relationships (33%)
  • Parent their children (23%)

What Factors Influence Mental Health in North Carolina the Most?

When it comes to North Carolinians’ mental health, the following factors have the biggest impact—both positively and negatively: 

  • Financial state (35%)
  • Family life (32%)
  • Romantic relationships (29%)
  • Sense of community (25%)
  • Personal hobbies and interests (24%)
  • Work and/or school (24%)
  • Their home (21%)

While finances were the most common answer, the small margin of difference between all responses is a reminder that mental health is personal. Everyone manages different areas of their life better than others, and each person who seeks mental health support does it for a unique and personal reason. 

Finances: One of the Top Stressors for North Carolinians

Nearly half of survey respondents (44%) said personal finances and the rising cost of living had negative repercussions on their mental health. Relationships were the next most common stressor, cited by 33% of respondents.

Personal finances and cost of living were the biggest stressors for North Carolinians in 2024, with relationships, family dynamics, social media use, political news, and natural disasters following.

Here’s a breakdown of the top contributors to North Carolinians’ mental health struggles this year: 

  • Personal finances/cost of living (44%)
  • Relationships (33%)
  • Family dynamics (32%)
  • Social media use (28%)
  • Political news and events (21%)
  • Natural disasters (21%)
  • Workplace issues (18%)
  • Crime rate (15%)
  • Contagious viruses and diseases (15%)
  • Social and racial inequities (15%)
  • International conflicts (10%)
  • Civil unrest (9%) 

Are North Carolinians Seeking Therapy?

A slight majority of North Carolinians (52%) plan to seek therapy in the next 12 months, leaving 48% who do not.

52% of North Carolinians plan to seek therapy, while 48% said they did not.

People cited a variety of reasons for not seeking therapy, the most common one being they didn’t feel it was necessary (66%). Time and money are other considerations: Nearly one-third of respondents said therapy was too expensive (30%), and another large group (18%) listed lack of time as their reason.

Other North Carolinians doubt therapy as a whole (15%), believing the process is ineffectual and doesn’t work.

Others still were slightly intimidated and confused by the therapy process, citing trouble finding a good fit (9%), a provider who takes their insurance (5%), or someone who prescribes mental health medications (4%) as inhibitors to care. Some respondents also had trouble figuring out how to apply their insurance to therapy (7%), complicating the process further.

Stigma is also a factor, with 8% of respondents saying they were too embarrassed to seek care. 

For those interested in therapy, Thriveworks North Carolina makes the process of finding a provider, making an appointment, and even establishing insurance coverage quick and easy, with both in-person and online sessions available to suit your needs.

Where Do People Turn for Support Outside of Therapy?

We asked North Carolinians who they would turn to for advice—besides a mental health professional—if something was troubling them. Unsurprisingly, reaching out to close connections like a family member, friend, or romantic partner was a popular choice (54%, 49%, and 39% respectively). A fair amount of respondents (13%) said they wouldn’t confide in anyone regarding their mental health—the sixth most common answer on the list.

Outside of family and friends, North Carolinians are most likely to lean on other trusted advisors, such as their primary care provider (21%) and religious leaders (17%).

Work might be another outlet for people in North Carolina, with some respondents saying they’re likely to look for support from their colleagues (8%) or their boss (4%). 

Strangers aren’t out of the question, either. Results show respondents might get in touch with social media influencers (7%), talk to an Uber driver or cabbie driver (1%), or even chat with an AI bot like ChatGPT (4%).

Outside of therapy, people in North Carolina said they would turn to family members (54%), friends (49%), romantic partners (39%), medical professionals (21%), and religious leaders (17%) for support, among others.

North Carolinians Shell Out for Their Mental Health—But Is It for Therapy?

Many survey respondents were willing to spend a considerable amount of money on their mental health in the last year. The average annual total spent on activities that support mental well-being was $2,354 per person. 

The most common use of those funds: travel and vacations—by an overwhelming margin—with therapy coming next on the list. 

Here are the top five mental health expenses for North Carolinians last year, plus the average amount spent on each:  

  1. Travel and vacations ($1,708)
  2. Therapy ($188)
  3. Self-care treatments (gym memberships, spa, etc.) ($122)
  4. Mental health-related prescription medication ($101)
  5. Emotional support animals ($70)

Mental health is a multi-faceted issue, with many effective options for support and treatment. People may often use more than one method to help cope.

North Carolinians spent an average of $2,354 for their mental health in 2024 on things like travel, therapy, medications, self-care treatments, and support animals.

Is North Carolina a Good Place to Live for Mental Health?

Yes, according to the majority of survey responses: 56% agree North Carolina is a good place to live for mental health. Another 35% report not feeling passionately either way, and only a small group (9%) disagrees. 

*This study was conducted in December 2024 by QuestionPro for Thriveworks through an online survey of 1,100+ adult North Carolina residents.