Why Are People Still Dying? America’s Behavioral Health Crisis
- 16 hours ago
- 8 min read
Tom McNulty, M.S., is a healthcare consultant with a vast array of experiences in behavioral health, neurology, healthcare hospitality, and health talk podcasting-"MindSet with Tom McNulty, M.S." He is a professional photographer, screenwriter, and public speaker.
Lives lost to suicide, overdoses, mass shootings, human trafficking, eating disorders, and trauma are rising despite several questionable government reports seeking to minimize the nation’s growing mental illness and addiction problems. The flawed belief is that these painful realities happen to someone else's family, in someone else's neighborhood, in some other community, or in some other country.
It is happening everywhere. We all know someone who has died because help was denied. Frontline people such as campus security, urgent care facilities, spiritual leaders, teachers and professors, ambulance personnel, law enforcement, caregivers, primary care physicians, military officers, parents, human resources directors, emergency room staff, and friends do not fully understand what to do when someone is in a life-threatening episode.
Behind the statistics are parents who don't know how to help their children. Families are watching someone they love disappear into addiction. Teenagers are fighting depression in silence. People with serious mental illness are cycling through emergency rooms, hospitals, shelters, and jails. Our prisons are housing more mentally ill individuals than psychiatric hospitals and addiction programs. Spouses who become caregivers do not know the warning signs. Children who grow up wondering whether Mom or Dad will survive another night live in fear of impending danger.
While “breaking news” may cover celebrity deaths from suicide and drug or alcohol overdoses, practically nothing with a behavioral health reference is mentioned after mass shootings leave communities in a state of unresolved trauma. Add human trafficking (Epstein was not alone), high school and college hazing, gambling with drugs laced with fentanyl, incest, workplace bullying, coronavirus disease 2019 (COVID-19) trauma and burnout, the impact of racism, military suicides, internet sites, teens gambling online, and seniors aged 65 and older dying from drug and alcohol mixtures. It’s no longer impactful to claim that stigma is the problem. To do nothing is to put children born today at severe risk of an ongoing fear of impending danger. As we know, America has more guns than people. How many mass shooters were discovered to have had serious mental illness, but treatment was ignored or failed the individual?
Sometimes, there is no next morning. But trauma, we now know, takes years off our lives.
Face the facts that it’s serious, and we need a solution
The newest federal data show the size of the crisis with uncomfortable clarity.
In 2025, an estimated 54.6 million American adults, 20.6% of the adult population, experienced a mental illness during the previous year. Of those, 18.2 million adults, 6.9%, experienced serious mental illness, a category involving conditions that substantially interfere with major life activities.
That means roughly one out of every five American adults was living with a mental illness during 2025.
But the crisis does not stop at adulthood. Do you have children?
Among America's adolescents ages 12 to 17, 3.7 million experienced a major depressive episode in 2025, 15.1% of the nation's teenagers. About 2.7 million experienced an episode with severe impairment.
Approximately 4.6 million adolescents, 18.0%, had moderate or severe symptoms of generalized anxiety during the two weeks preceding the 2025 survey.
Addiction is another front in the same war
In 2025, 44.6 million Americans aged 12 and older, 15.3% of the population, met the criteria for a substance use disorder during the previous year.
Among those known to authorities and providers:
26.0 million had a drug use disorder.
25.7 million had an alcohol use disorder.
19.3 million had a marijuana use disorder.
4.5 million had a central nervous system stimulant use disorder.
4.0 million had an opioid use disorder.
7.1 million had both an alcohol use disorder and a drug use disorder.
The numbers overlap because a person can have more than one drug use disorder.
The opioid number is particularly sobering. Fentanyl adds to the sudden death rate. It only takes the equivalent of a pencil tip of fentanyl to cause an overdose.
Approximately 4 million Americans had a reported opioid use disorder in 2025. Many users are not known or recorded as users, even those saved by Narcan. Addiction does not exist in a vacuum. It’s rampant at every socioeconomic level of life, from Wall Street to those living in poverty.
In 2025, 33.9% of adults with any mental illness, 18.5 million people, also had a substance use disorder.
This is one of the most important facts in the entire behavioral health story. You cannot fully address addiction while ignoring mental health, and you cannot fully address serious mental illness while ignoring addiction. This is just one of the blatant failures of the treatment systems and insurance payers.
They are diseases that often intersect but are not treated with a holistic assessment and treatment plan.
The treatment gap is one of the greatest horrors
Perhaps the most disturbing part of the statistics isn't how many Americans are suffering. It is how many are suffering without treatment. Why? Poor assessment and referral procedures and a lack of appropriate and timely access.
Among adults with mental illness in 2025, 54.6 million were affected. Yet only 27.8 million, 50.9%, received mental health treatment. That means approximately 26.9 million adults with a mental illness did not receive mental health treatment.
For substance use, the gap is even more stark.
Among people aged 12 and older who needed drug or alcohol use treatment in 2025, only 16.0%, 7.6 million people, received treatment. That means roughly 84% did not. The treatment gap was particularly severe among young adults, only 9.6% of 18-to 25-year-olds who needed substance use treatment received it.
Think about what that means.
Millions of Americans are experiencing a condition serious enough to meet the criteria for treatment, and most are not receiving it. Why?
The most tragic number: The people who die
The behavioral health crisis ultimately becomes a mortality crisis, but these are lives that could have been saved.
The Centers for Disease Control and Prevention (CDC) provisional mortality report estimates that 48,789 Americans died by suicide in 2025. Suicide was the nation's 11th leading cause of death that year. That is approximately 134 deaths every day. More than 4,000 every month.
Every one represents a person whose absence permanently changes other people's lives.
The mother who never gets another phone call. The father who never gets to see another birthday. The child who grows up without a parent or sibling. The friend who keeps asking, What could I have done? The coworker whose empty chair becomes a permanent reminder.
Suicide is therefore not simply a statistic about an individual. Family and friends are traumatized for life. It is a trauma ripple that moves through families, workplaces, schools, and entire communities and lingers for years.
The overdose numbers might be falling, but the crisis is still enormous
There is, importantly, some good news. Or is there?
America's overdose death rate has been falling in a few states. Typically, overdose rates do not include alcohol, and there’s a category that comes from many coroners’ offices, “Suspected but not confirmed.” This category includes the driver who crashes off a road or into a wall at a very high speed. Was it suicide or an accident? Intoxication? Too often, it’s reported as an accident.
The CDC estimates that approximately 69,973 people died from drug overdoses in 2025, down nearly 14% from an estimated 81,313 deaths in 2024. For perspective, there were 58,200 U.S. military personnel killed in the entire Vietnam War.
That CDC-reported decline represents thousands of lives saved or deaths families never reported. It should be examined in more detail, but it should never be confused with victory. More than 70,000 Americans still died from drug overdoses in one year. That is approximately 192 people every day. Eight people every hour. Roughly one American every five minutes. The story has continued into 2026.
The latest CDC provisional national data, covering the 12 months ending February 2026, predict 68,641 drug overdose deaths, a further 12.1% decline from the preceding 12-month period. That is encouraging to some. That number represents a rolling 12-month period from March 2025 through February 2026.
The honest conclusion is therefore simple, we do not yet have the final national first-half 2026 mortality numbers or a totally accurate account of deaths.
But the damage extends far beyond death
Death is only the most visible measure.
There are millions of people who survive an overdose but are left with medical complications, neurological injuries, trauma, disability, or another trip to the emergency department. There are families financially devastated by addiction. There are children living with the unpredictability of a parent's substance use. There are marriages destroyed. There are jobs lost.
There are businesses dealing with absenteeism, impaired performance, and employee behavioral health problems. These costs stretch into the billions of dollars every year. There are police officers repeatedly responding to the same behavioral health emergencies. There are emergency departments functioning as the nation's de facto mental health safety net.
There are hospitals treating the consequences of conditions that often should have been identified and addressed much earlier in primary care, but do mentally ill and addicted individuals have regular checkups?
There are communities trying to manage homelessness, public disorder, addiction, and serious mental illness without enough resources to address the underlying causes.
This is why behavioral health cannot be viewed solely as a medical specialty. It is a community issue. It is an education issue. It is a public safety issue. It is an economic issue. It is a family issue. It is a workforce issue. Ultimately, it is a human issue.
A solution-based answer exists: The Episodes Project
The Episodes Project is a three-component, interactive learning program utilizing customized interactive theater. It contains a full-length feature film, a community training program (Spotlight on the Community) for frontliners, and a 50-episode streaming series to keep the momentum going. It is supported by a detailed website with archived shows, trainings, skills and tools, and resources.
Professional actors, with behavioral health therapist facilitators, take the audience, frontliners, into their own world and coach them using more effective ways of handling a troubled citizen and saving lives. To learn more about The Episodes Project, contact the author of this article here.
Read more from Thomas Patrick McNulty
Thomas Patrick McNulty, CEO of Success Stories, Inc.
Tom McNulty, M.S., developed his interest in psychology and the brain in high school while attending college at the same time. His interests grew, and he received his master's degree. After graduation, he worked in a psychiatric hospital as a family therapist, and then he was offered a management position to work with troubled adolescents. Tom took his passion to the airwaves and hosted a weekly health talk radio program for 18 years. He is the founding partner of HHPartners (healthcare hospitality consulting) and co-creator of The Episodes Project (behavioral health). His mission: "Creating Enduring Impact".
Primary sources:
SAMHSA: 2025 National Survey on Drug Use and Health. The newest national survey of mental health, substance use, addiction, and treatment.
CDC/NCHS: Mortality in the United States: Provisional Data, 2025. Provisional national mortality data, including the 2025 suicide count.
CDC: Provisional Drug Overdose Data. Current national overdose estimates and methodology.*
CDC: 2026 Statistical Release Schedule. Shows when national provisional overdose data covering June 2026 are scheduled to become available.
The Episodes Project 2026: Behavioral Health. A three-component, solution- and data-driven global program designed to “Create Enduring Impact.” * The overdose report covering January–June 2026 is not scheduled to be released until November 2026.
