For a lot of people mental health and substance use overlap, despite it frequently being looked at as two separate problems. A recent study using national data from 2021–2023 found that adults with more severe mental illness were more likely to receive substance use treatment. At the same time, they were also more likely to report needing treatment but not receiving it.
The study found that only about 11% of adults with a non-alcohol substance use disorder received treatment in the past year. Even though treatment became more common as mental illness became more severe, the numbers were still low. Treatment rates increased with mental illness severity, from 7.3% among those with no reported mental illness to nearly 18% among those with severe mental illness.
The biggest concern is what happens when someone knows they need help but still cannot access it. Barriers to care can include unstable housing, criminal legal involvement, and difficulty navigating multiple systems of care. For people living with both mental illness and a substance use disorder, getting care can be significantly more complicated. The study found that about 6.3% experienced housing instability, compared to 2.9% of those without mental illness and 11.3% had criminal legal involvement.
The researchers emphasized that added stress could make it more difficult to stay consistent with care. Encouraging people to seek help is an important first step, but it cannot be the only one. People also need to be able to find care that is accessible and able to address both their substance use and mental health needs at the same time.
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Reference:
Waghmare, S. A., Shearer, R. D., Segel, J. E., & Jones, A. A. (2026). Co-occurring mental illness and substance use disorders: Associations between illness severity, perceived need, and receiving substance use treatment. Substance Use: Research and Treatment, 20. https://doi.org/10.1177/29768357261492867
