• 23% of survey respondents are currently seeing a therapist and 43% plan to see a therapist within the next 12 months.
  • 88% of Americans feel comfortable openly sharing that they are in therapy with at least one other person in their life.
  • Therapy is cited as a vital pillar of wellness for 36% of respondents, equivalent to maintaining a healthy diet and regular exercise, while 53% consider therapy crucial during low moods or stressful circumstances.
  • The majority of respondents (87%) report experiencing benefits from therapy, including increased confidence (53%), enhanced happiness (46%), and improved self-esteem (44%), underscoring its role in personal growth

A recent survey commissioned by Thriveworks unveils compelling patterns in American perceptions of mental health and seeking mental health treatment. 

These key insights outline whom we’re most likely to tell about our mental health challenges, which generation is most likely to seek therapy and much more.

Who Is in Therapy—or Plans to Be? 

At present, nearly a quarter of Americans (23%) see a therapist, either regularly, or on an occasional basis. A larger amount, (37%) have consulted with a therapist within the last 2 years, but are no longer in sessions, while still more (40%) have never been to therapy.

Looking ahead, a large section of respondents (43%) express plans to see a therapist in the next 12 months, compared to others (57%) who have no plans to begin therapy.

A quarter of Americans who don't go to therapy cite cost as the barrier

Breaking down the data by generations, Millennials are most open to attending therapy (38%). Gen Z is next (27%) followed by Gen X (23%), and Baby Boomers (9%). 

From a regional perspective, the proportion of Americans who see a therapist either regularly or on an as-needed basis decreases from east to west with the largest dip in the midwest: Northeast (26%), South (23%), Midwest (18%), West (22%).

 Interestingly, those in the West have the smallest proportion of individuals who have never been to therapy at all (37%, compared to 40% in the Northeast, 41% in the Midwest, and 42% in the South).  

Intention to see a therapist within the next 12 months is strong in the Northeast (48%), South (46%), and West (45%) but dips by more than 10 percentage points in the Midwest (32%).

What Are the Reasons Americans Don’t Go to Therapy? 

Of those who have never attended or have stopped therapy, the most commonly reported reason for not attending is that they’ve never felt the need for therapy, which is indicated by 58% of respondents. 25% of all respondents cite therapy as too expensive. 

Insurance-related concerns pose a barrier (13%), difficulty finding the right therapist (10%), and being unable to schedule appointments when needed (7%). Negative past experiences with counselors are also an influence (6%), as well as embarrassment (5%), skepticism about therapy’s effectiveness (4%), and not wanting one’s employer to find out (2%). 

Reasons that Americans don't go to therapy

8% cite various other reasons, highlighting the multifaceted factors influencing therapy decisions.

From a multi-generational viewpoint, the cost of therapy is cited as a reason for not recently (or ever) having sought out therapy for:

  • 39% of Millennials
  • 36% of Gen Z
  • 28% of Gen X 
  • 13% of Baby Boomers

Time constraints also contribute (13%). Gen Z and Millennials are most affected by time constraints at 28% and 24%, respectively, while Gen X (9%) and Baby Boomers (5%) indicate that they are less affected by a lack of time.

People in the West were the least likely to report not feeling the need for therapy (51% compared to 63% in the Midwest, 61% in the Northeast, and 58% in the South), but the most likely region to report expense (28% compared to 20% in the Northeast and 25% in both the South and Midwest) and not having enough time (18% compared to 12% in the South and 11% in each the Northeast and Midwest) as the reasons they don’t receive mental health services. 

A quarter of Americans who don't go to therapy cite cost as the barrier

Americans Feel Comfortable Sharing That They’re in Therapy 

A notable majority of Americans (88%) feel comfortable openly sharing that they are in therapy with at least one other person in their life. This was fairly evenly split across regions (Northeast (87%), South (89%), Midwest (88%), and West (89%). Breaking the numbers down further, more than half feel comfortable informing their immediate family (57%), and another sizable portion (52%) indicate that they feel comfortable informing a romantic partner.

The majority of Americans feel comfortable sharing they are engaging in mental health services

Close friends (44%) follow behind, with even less amount reporting feeling okay sharing their therapy journey on social media (12%). Similarly, few feel comfortable disclosing they’re in therapy to coworkers (11%), and even less so with bosses (10%). 

Notably, some Americans (12%) don’t feel comfortable sharing their therapy engagement with anyone. 

We Share More with Our Therapists Than Those Closest to Us 

Two-thirds of Americans (66%) say they are more comfortable sharing things with their therapist than with their partner, friends, and family. Those identifying as men are more comfortable sharing their problems with their therapist than with those close to them (36% of men vs 23% of women). 

Generationally, Millennials are overwhelmingly more comfortable sharing with their therapist than those close to them (78% of Millennials strongly or somewhat agree, compared to 62% of Gen Z, 68% of Gen X, and 52% of Baby Boomer respondents.)

From a regional perspective, comfort levels of sharing with a therapist over a loved one jumped considerably in the Northeast (74%), compared to the South (66%) and West (63%) with an even further dip in the Midwest (59%). 

Who Do We Confide in When We’re Struggling with Personal Problems, If Not a Therapist? 

The survey reveals diverse emotional support preferences when it comes to who we confide in.

Outside of their therapist, Americans turn to the following with personal issues

Americans were most likely to discuss their problems with: 

  • A family member (56%)
  • A close friend (55%)
  • A spouse or romantic partner (46%)
  • Medical professionals (22%)
  • Religious leaders (17%)
  • Those on social media forums (8%) 

22% of Americans turn to medical professionals to share personal problems

Other sources included coworkers (8%), Uber or taxi drivers (3%), and bartenders (3%), with only a few (2%) mentioning their manicurist. Notably, 7% prefer not to confide in anyone.  

In summary, 93% express a willingness to seek support from various sources.

What Is Making Americans Anxious? 

The survey provides insights into the sources of anxiety among Americans. Foremost among these are personal finance and the escalating cost of living (58%).

Personal finances and the escalating cost of living is the leading cause of Anxiety for Americans

Wars and conflicts weigh heavily on the minds of Americans (46%), as well as heightened anxiety due to the perceived increase in crime (43%). 

Natural disasters (32%) also contribute to the anxiety of respondents, with contagious diseases, such as the ongoing COVID pandemic, identified by an equal percentage. Political news and events, including election coverage (31%) follow closely, and social and racial inequities also emerge as significant stressors (28%).

Climate change and its repercussions on the planet register as a source of anxiety (27%), while a smaller number (13%) of respondents indicate that none of the mentioned factors cause them anxiety, suggesting a diversity of perspectives on the causes of emotional distress.

What Is Making Americans Anxious?

How Do People Work Therapy into Their Lives?

The data may suggest that therapy is recognized as a core pillar of American wellness and self-care. A significant portion of the population (36%) views therapy as a crucial component of their holistic well-being practices, comparable to exercising regularly and maintaining a healthy diet.

A majority of respondents (53%) consider therapy important when they are experiencing low moods or navigating stressful circumstances and situations. An equal number (53%) report that they would contemplate seeking therapy in the wake of a stressful or traumatic event.

What Are the Benefits People Report Experiencing While in Therapy? 

The survey explores the perceived benefits of therapy among respondents, of which 87% report experiencing one or more.

The majority of people in therapy report experiencing one or more benefits (87%)

A majority (53%) indicate that increased confidence in their ability to overcome personal challenges is the primary benefit of attending therapy.

Other notable benefits reported by survey respondents include:

  • Enhanced overall happiness (46%)
  • Improvement in self-esteem  (44%) 
  • Positive effects on interpersonal dynamics (42%) 
  • Better physical health (30%) 

The benefits people report experiencing while in therapy

A smaller number (6%) cite other benefits not explicitly listed, while only a few (13%) report that they haven’t personally experienced any positive outcomes from therapy. 

The cumulative data reveals that 87% of respondents report experiencing various benefits from therapy, underscoring its significant role in fostering personal growth and well-being.

*This study was conducted by Wakefield Research and commissioned by Thriveworks in November 2023 through an online survey of over 2,000 US Adults.