Thriveworks 2026 Pulse on Mental Health Report: American attitudes toward therapy, AI, and mental health care

The conversation about mental health in America has never been louder—or more complicated—than it is in 2026.

On social media, therapists are posting daily videos alongside ads for AI tools promising to replace them. In the news, politicians are weighing in regularly on who should get care, how they should get it, and whether the treatments currently available can be trusted. Every day, global events bring something new to feel anxious about—and everyone from wellness influencers to supplement brands are competing to sell you something for your “dysregulated nervous system.”

And yet, when you ask Americans what actually helps, the simple answer cuts through: sitting in a room (even a virtual one) with a person who’s there to listen without judgment and help them find steadiness in a world that offers very little of it.

In Thriveworks’ third annual look at American attitudes toward mental health and mental health care—based on a nationally representative survey of 2,000 adults conducted by Wakefield Research in March 2026—we explore shifting attitudes toward therapy and medication, the rise of AI as both an anxiety and a proposed solution, and the deeply human needs that sit at the center of it all.

Prefer reading a PDF? View or download the full 2026 Pulse on Mental Health Report here.

More Americans have been to therapy than ever. So why do so many stop?

Therapy has crossed an exciting threshold. For the first time, a clear majority of Americans—62%—have consulted a mental health professional at some point, up from 43% in 2023 and 48% in 2025.

And yet, only 27% are currently in care, with 15% seeing someone on an ongoing basis.

One reason for this gap could be the logistical barriers to ongoing care. While telehealth has made therapy easier to access, it still requires a time commitment and can be a financial burden depending on health care coverage and budget. There’s also still some lingering stigma, particularly among older generations.

Part of the challenge lies in the difference between trying therapy and finding the right therapist, says Jami Dumler, LCSW, clinical programs director at Thriveworks. The trial-and-error of identifying the best therapeutic approach and personality fit can cause some people to drop off. “If you have the courage to set up a therapy intake and you don’t have a great experience, it can be really hard to try again,” Dumler says.

On the flip side, not needing ongoing care can be a feature of therapy, rather than a bug, says Kate Hanselman, PMHNP, VP of clinical psychiatry at Thriveworks. People resolve an acute crisis and can step away for a while, feel stabilized with the help of medication, or have learned the tools to manage more on their own.

And when something new comes up, the path back is easier. This aligns with the 47% of Americans who indicated that they’re likely to seek care in the next 12 months (consistent with 48% in 2025, up from 43% in 2023). “The doors stay open,” Hanselman says. “If you need to come back and see me, it’s not the first time we’ve met.”

Money is still the top stressor. But our anxieties are getting more complicated

While personal finances and cost of living remain the leading source of anxiety, with 48% of Americans indicating it causes them concern, that number is notably down from 54% in 2025. This seems surprising in a world where rising prices are a part of the conversation every day—until you think about all the other things we have to be stressed about.

For example, concern about political news and global events has climbed slightly: 38% of Americans indicate it as a stressor compared to 36% last year, with Boomers in particular more anxious about politics (46%) than finances (37%).

“I’m not that worried about my bank account if I’m also worried that something catastrophic is going to happen geopolitically,” Hanselman says. Part of what makes political anxiety so hard to manage is the nature of how we consume it. “It used to be that you’d get the news maybe once a day. But when we consume this much media, this fast, our brains get really overwhelmed thinking that whatever’s happening way over there is actually in our present,” she says.

Dumler has seen this play out clinically. “Politics and world headlines are coming into the therapy room more than they ever used to, and at younger ages,” she says, explaining that kids as young as elementary school will share concerns about what’s happening in the world.

The numbers also differ depending on who you talk to: while 29% of Americans at large indicate workplace stress and job security as a concern, 43% of Millennials feel this way versus just 9% of Boomers. Millennials also have higher rates of anxiety around family and relationship dynamics than any other generation, at 43% compared to the national average of 34%.

“These younger generations are sandwiched between tradition and new-age ways of doing things, which can create challenging dynamics to navigate—alongside the pressures of caring for their aging loved ones and parenting the next generation,” Dumler says.

And then there’s AI, which is new to the anxiety list entirely this year, with 21% of Americans saying it’s a source of stress—even as the technology is increasingly being pitched as a mental health solution.

Americans are skeptical of AI in therapy. But younger generations tell a different story

The majority of people are hesitant about AI entering the therapeutic space: Nearly 2 in 3 Americans (64%) have less confidence in AI than human therapists for mental health support, and 1 in 2 (51%) say AI should have no role in the therapy process at all.

What Americans worry AI can’t do reveals what they value most about the therapeutic relationship. “Two humans in a room—that is what this is about, especially in modern times where we have this loneliness epidemic,” Hanselman says.

“What AI does not have is real-world life experiences. I’m another human that can relate, validate, and even maybe has been through what that client has been through,” agrees Dumler, who also says breakthroughs can happen thanks to nonverbal cues she notices in the therapy room—something AI can’t replicate.

Dig deeper into the data, however, and you’ll notice a more nuanced picture. For instance, skepticism toward AI in mental health care drops steadily with each younger generation. The majority of Boomers (69%) want AI out of the process entirely, with 45% against its use even for admin tasks like scheduling. Talk to Gen Z, and that number is halved, with 41% actually expressing openness to AI as an alternative to therapy. It’s worth noting that among those who have already tried AI mental health tools, 35% across generations found them just as effective as traditional care.

Most Americans who are open to AI in mental health care want it kept in a supporting role—as a supplemental resource (27%) or administrative tool that never enters the therapy room (21%). Among those who have actually tried AI mental health tools, that’s largely how it’s playing out: 75% used it as a supplement to therapy, not a replacement.

Dumler and Hanselman have both seen how AI can be valuable as a supportive tool, using it to create resources that patients can use between sessions, such as worksheets or chatbots for practicing skills. They also think it can help people normalize and understand their symptoms, giving them the nudge to seek care and some tactics to tide them over until they see someone.

At the end of the day, AI can be present when therapists can’t. “I can’t be available to you 24/7,” Hanselman says. “When things feel really hard in the middle of the night, if you live alone and don’t have a partner or a friend you can call, AI can help people feel less alone.”

People share more with their therapist than anyone else in their lives

In the midst of these major shifts to mental health care, one of the most human benefits has remained remarkably strong: 72% of people who’ve seen a therapist feel more comfortable sharing with their therapist than with a partner, family, or close friends—up from 66% in both 2023 and 2025.

This doesn’t surprise or worry Dumler. “Where else in your life do you have an hour that is about you, for you, with a nonjudgmental third party who is all in listening to you?” she explains, adding that the confidentiality and lack of bias built into the therapeutic relationship add to that feeling of safety.

Men and parents skew particularly high on this front: 78% of men agree they’re more comfortable sharing things with a therapist compared to 68% of women, and 81% of parents versus 67% of non-parents.

Both point to the same underlying dynamic: The people most likely to feel they can’t fully open up elsewhere—men because of cultural norms around emotional weakness and parents who are accustomed to putting everyone else first—are the ones who lean most heavily on the therapeutic relationship when they have it.

Hanselman describes the therapeutic relationship as a rare space for the things people haven’t told anyone. “The things that you won’t tell anybody else—that you’d take to your grave—you can come tell me, and we can get it out in the sunlight and shed some of that shame,” she says.

Ultimately, a trusted therapeutic relationship can benefit our day-to-day relationships, Dumler says. “It can be really empowering and educational to have a relationship where you can misstep and communicate through it,” she continues. “When you practice that with your therapist in a safe space, you can build that skill, build that confidence, and translate that into your other relationships.”

Nearly half of Americans have used mental health medication. But many still have reservations

Mental health medication has quietly become common. Talk therapy remains the foundation—86% of Americans would seek it if consulting a mental health professional—but nearly half (49%) would want medication as part of their care as well. And yet, despite the fact that nearly half of Americans (47%) have been prescribed medication at some point and 24% are currently taking it, 68% still have at least one hesitation.

Concerns about side effects or long-term dependency lead the list at 36%. Hanselman traces this partly to older generations’ experiences with harsher medications, and notes that these concerns are often magnified by the very symptoms medication is meant to treat, such as anxiety and depression.

Meanwhile, 1 in 4 Americans (25%) think they should be able to handle their challenges on their own. “There’s still this cultural stigma that mental health medication is a weakness or a problem,” Dumler says. “But if you broke your arm and someone said you needed surgery, you wouldn’t say, ‘That’s for weak people.’ You’d get that surgery. It’s the same idea with mental health.”

Hanselman thinks that belief is deeply baked into American culture. “We’re very bootstrappy,” she says. “People see taking medication as the easy path, but what’s wrong with the easy path?”

Evidence shows that the “easy” path is also more effective: Combined treatment leads to faster, more sustained symptom relief. “Therapy is easier if you have meds on board,” Hanselman says. “Meds work better if you have therapy on board.”

Your body is keeping score. And so is your schedule

Americans have largely come to terms with the fact that their mental health doesn’t exist in a vacuum. In particular, there’s a deeper understanding of how our external world affects our inner one.

Take the mind-body connection: Nearly 4 in 5 people (79%) say physical ailments affect their mental well-being at least somewhat, with 1 in 5 (20%) who say it has a great deal of impact.

Dumler thinks this understanding is probably thanks to the popularity of wellness content on social media, but feels we still have work to do when putting it into practice. “Society is too focused on health as it relates to supplements, diets, or products instead of asking if we’re doing the basics—rest, water, whole foods, good nutrients.”

She also hopes for a future where providers do a better job collaborating across specialties: “Whether you’re going to your primary care doctor, your OB-GYN, or your mental health provider, those worlds should be talking to each other.”

Americans also have a growing understanding of the weight their calendar can carry, with more than half (51%) feeling happy or relieved at least occasionally when a friend cancels plans.

Dumler thinks this JOMO (joy of missing out) is a holdover from the COVID-19 pandemic: “We had to pause some of our busyness and social life, and people adjusted to that. It felt good to have slower lives.” While it’s good that people are doing a better job at understanding their social batteries and setting some boundaries, she hopes that doesn’t come at the cost of building community, which is just as important for mental health.

For most people who go, therapy works

Amidst all the other shifting anxieties and opinions, one fact remains clear: therapy works. More than 4 in 5 of those who’ve seen a therapist (85%) report meaningful benefits, including improved confidence and self-esteem, better relationships, and greater overall happiness.

It’s worth turning down the volume on everything else and remembering that.

The tools, the technology, and the conversation around mental health will keep evolving. The list of things to be anxious about may keep getting longer. But if we can get people through the door, asking another human being for support, we can find ways to carry it all.

*This survey was conducted by Wakefield Research among 2,000 nationally representative U.S. adults ages 18+, plus an oversample to a total of 100 adults who have used AI-powered mental health solutions, between March 13 and March 22, 2026, using an email invitation and an online survey. Data has been weighted.