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January 3, 2025
Quarterly Article
Jake Haselswerdt
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Policy Points:
Context: Mental health problems represent a major public health issue for the United States, and access to mental health treatment is both inadequate and unevenly distributed. There is a strong justification for government action on mental health treatment, but it is unclear whether there is a political constituency for such action. Existing work suggests that stigma and othering of people with mental illnesses contributes to reduced support for intervention. I expand on the existing literature by focusing on mental health as an issue that may apply to Americans’ own lives rather than only to a stigmatized outgroup.
Methods: Using original questions on a nationally representative 2023 survey of 1,000 American adults, I measured agreement with statements about barriers to mental health treatment access that respondents have experienced or, if they have not sought treatment, their hypothetical assessment of these barriers. I also measured their support for statements in favor of change to address mental health. I analyzed the demographic and political correlates of agreement with the barrier statements and used regressions to examine their possible causal effect on support for change.
Findings: Agreement with statements about access barriers follows expected patterns in some cases (e.g., socioeconomic status) but not in others (e.g., race/ethnicity). I also documented a notable partisan and ideological divide in these experiences and beliefs. I found that Americans who agreed that material factors are a barrier to access were more supportive of action on mental health, whereas those who agreed with statements suggesting discomfort or skepticism were less supportive.
Conclusions: These findings suggest that personal experience and perspective-taking should be integrated into the study of public opinion on mental health, complementing existing work on stigma and othering. Appeals to experience and perspective-taking may be a successful strategy for building public support for action on mental health.
