Editor’s Note: This research was conducted in partnership with the West Health-Gallup Center on Healthcare in America, a joint initiative to report the voices and experiences of Americans within the healthcare system.
WASHINGTON, D.C. — Americans’ assessments of their own mental health continue to erode. For the first time, the percentage of U.S. adults who describe their mental health as “excellent” has dropped below 30%. Just six years ago, before the COVID-19 pandemic, 43% rated their mental health this positively.
In addition to the 29% who now say their mental health is excellent, 43% describe it as good. The combined 72% rating their mental health as excellent or good is also a low by three percentage points.
These results are based on the Nov. 3-25 West Health-Gallup Healthcare survey.
The COVID-19 pandemic appears to have been a turning point in the way Americans view their mental health. Before the pandemic, people’s evaluations of their mental health were quite stable, with 42% or more rating their mental health as excellent in every year from 2001 through 2019. The rating fell nine points to 34% in Gallup’s November 2020 update, conducted about eight months after the pandemic began in the U.S.
Americans’ self-reported mental health has worsened since 2019 among all major demographic subgroups. This is based on a comparison of 2014-2019 data (the six years before the pandemic) to 2020-2025 data (the six years since the pandemic began). However, younger generations of adults and college graduates have shown larger declines than older Americans and those with less formal education.
Specifically, over the past six years, the percentage of Generation Z and millennial adults who report excellent mental health has declined by about 15 points in each group. That compares with an 11-point decline for Generation X adults and smaller drops among baby boomers and Silent Generation adults. On average over the past six years, 23% of Gen Z and 28% of millennial adults rated their mental health as excellent, compared with no less than 34% of those in older generations.
College graduates’ excellent mental health ratings are 17 points lower than in the 2014-2019 period, compared with a 10-point decline among those without a college degree. Whereas college graduates used to have significantly better mental health ratings than nongraduates, the two have been much more similar in recent years.
Declines in mental health ratings have been about the same size among men and women. Among racial and ethnic groups, the declines have been greater for White and Black Americans than for Hispanic Americans. Democrats have had a smaller decline than Republicans and independents.
Mental Health Visits More Common Than in the Past
As Americans’ self-reported mental health has deteriorated, their efforts to seek help have increased. Twenty-four percent of U.S. adults say they have visited a mental health professional in the past year, including 8% who did so more than 10 times. The average number of visits among all U.S. adults is 3.2, up sharply from 1.1 in 2001 and 1.5 in 2004.
In line with their higher likelihood to report poor mental health, younger adults are more likely to have seen a mental health professional this past year. Thirty-six percent of Gen Z adults and 29% of millennials report doing so, compared with 22% of Gen X adults, 14% of baby boomers and 7% of those in the Silent Generation.
Gen Z and millennial adults average over four mental health visits a year, more than double the rate for those in the baby boom and Silent generations.
Physical Health Ratings Have Shown Little Change
In contrast to the sharp decline in mental health ratings, Americans’ assessments of their physical health have declined only modestly, from an average 29% “excellent” ratings (and 79% excellent or good ratings) in 2014-2019 to 26% (and 77%) over the past six years.
In the latest survey, 25% of U.S. adults describe their physical health as excellent, 52% as good, 18% as only fair and 4% as poor.
Whereas mental health ratings tend to be better among older than younger Americans, the opposite is true for physical health ratings. On average over the past six years, 36% of Gen Z adults, 30% of millennials, 25% of Gen X adults, 20% of baby boomers and 16% of Silent Generation adults have rated their physical health as excellent.
Americans Keeping Up With Routine Doctor Visits
While mental health visits have increased over time, visits to medical doctors have been fairly consistent. The average U.S. adult reports having gone to a medical doctor 5.3 times in the past year, similar to the average 4.7 visits measured in 2001.
Additionally, 76% of U.S. adults say they have had “a routine medical checkup” in the past year, essentially the same as the 78% measured in 2005, the last time the question was asked. Ninety-two percent of adults aged 65 and older say they have had a routine checkup in the past year, compared with 85% of those aged 50 to 64, 70% of those aged 30 to 49 and 61% of those aged 18 to 29.
Sixty-three percent of U.S. adults say they are confident in the accuracy of advice they get from their doctors, while 34% say they feel it is necessary to check for second opinions or do their own research. These figures are similar to what Gallup measured in 2002 and 2021, but slightly lower than in 2010, when 70% trusted their doctors’ advice.
There are notable age and party differences in the extent to which people trust their doctors’ advice. Older Americans are more inclined than younger Americans to trust what their doctors say, with 77% of adults aged 65 and older having confidence. This drops to 67% among those between the ages of 50 and 64 and is below 60% among adults between the ages of 30 and 49 (53%) and under age 30 (58%).
Democrats (74%) are significantly more likely than Republicans (62%) and independents (57%) to trust what their doctors say without seeking additional information.
Gallup had previously documented a decline in trust among Republicans (including Republican-leaning independents) compared with the early 2000s and an increase among Democrats and Democratic-leaning independents; there has been little change in party ratings in the current poll.
Bottom Line
After roughly two decades of stability, Americans’ ratings of their mental health have fallen to new lows over the past six years. Meanwhile, their assessments of their physical health have shown only a slight drop and remain largely similar to where they have been over the past 25 years.
The decline in mental health ratings is seen among all subgroups, but the changes are being led to a large degree by younger Americans, who, in turn, are most inclined to seek mental health treatment. Young adults have grown up in an age when mental health struggles are more openly acknowledged than in the past, and the medical community and other institutions such as employers and government are emphasizing the importance of mental and emotional wellbeing. That may make Americans, particularly young adults, more comfortable expressing that their mental health is subpar. Young adults, many of whom entered adulthood during the height of the pandemic, may also have been affected more by the threats to public health and the restrictions on normal activities in 2020 and 2021.
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