Hello,

Each year, the National Survey on Drug Use and Health (NSDUH) gives the mental health field its clearest national snapshot of who's getting care, who isn't, and what's changing. The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released the 2025 results, and we wanted to highlight what stood out to us at the Center for Mental Health Implementation Support (CMHIS), and where we see meaningful, practical opportunities for action.

Below are four findings we think matter most for mental health care organizations and systems, paired with the implementation question they raise.

1. About half of adults with a mental illness got treatment this year.

Roughly half of adults with any mental illness received mental health treatment in 2025. Among adults with serious mental illness (SMI), an estimated 5.9 million did not receive treatment at all.

The implementation question: If half the people who need care aren't getting it, how can you make sure your services are valued and needed by your community? Our guide on Powering Implementation Through Lived Experience Engagement and a recorded series on Advancing Access to Mental Health Services through Single Session Interventions both speak directly to closing that kind of access gap.

2. Suicide plans and attempts rose among adults, even though serious thoughts of suicide didn't.

Between 2021 and 2025, the share of adults reporting a suicide plan or a suicide attempt increased, while the rate of serious suicidal thoughts held steady. That gap is where systems have the most leverage.

The implementation question: What does your data show about how quickly your system responds once risk is identified, and who's responsible for that follow-through? Using Data to Improve Service Delivery covers how to build that kind of continuous feedback loop. If you're working through this now, request support — this is exactly the kind of implementation problem we help organizations work through.

3. Adolescent depression and suicidal thoughts are down, but 42% of adolescents with depression still went untreated.

Major depressive episodes and suicidal thoughts and behaviors among adolescents decreased from 2021 to 2025: real, encouraging movement. At the same time, an estimated 42% of adolescents with a past-year major depressive episode did not receive mental health treatment.

The implementation question: As youth mental health trends move in the right direction, is your organization positioned to reach the four in 10 adolescents still not connected to care? Engaging the Community and Assessing Their Mental Health Needs and materials on marketing programs and services can assist you in building your adolescent referral sources and making sure your community knows about your work.

4. More adults than ever consider themselves in recovery.

Among adults who reported ever having a mental health issue, 69% now consider themselves in recovery or recovered, up from prior years. This is a clear sign of progress, and it's worth considering how we can keep these numbers moving in the right direction.

The implementation question: With recovery numbers climbing, what's your plan for sustaining what's working? Our Sustainment Measurement System Scale and Selecting What to Sustain exercise are both built for that exact moment.

Where to go from here:

• Browse the full CMHIS Resource Library for tools to support you with taking action.
• Explore the Learning Lab for self-paced online courses and recorded learning sessions.
• Request support if you're already working through one of these problems and want a thought partner.

Thank you for the work you're doing. We're glad to be part of it with you.

Heather Gotham 

Principal Investigator & Director, Center for Mental Health Implementation Support (CMHIS) cmhis@cmhisupport.org

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This project is supported by Grant Number SM090078 from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of SAMHSA/HHS or the U.S. Government.