Millennials Say Mental Health Care Is a Basic Necessity. 78% Aren't Getting It.

Ten years ago, the anxiety I've lived with for much of my life started to flare up. I was so continuously anxious, I could barely function. It was affecting my professional performance, my appetite, my sleep…everything. One day, as I lay on the floor just trying to calm my body down, I knew I needed some help.

The struggle to access mental health care is real

But it took me a while to find a therapist, and then to find a time to meet with that therapist. Once I did those things, I quickly realized that fitting therapy into my schedule was going to be a real challenge.

I was working a demanding full-time job, and on the days I was able to squeeze in a therapy session, I found myself so nervous about meeting deadlines before it was time to head out for my appointments. During my sessions, I was on edge about not checking my email and team communication channels; I constantly worried about missing a work notification. In some ways, seeking out this mental health care felt like a stressor — and that's not because therapy doesn't work; it's because so many factors of daily life didn't lend themselves to me getting the mental health care I needed.

At some point, it became too much. I had to stop going to therapy because I just…didn't have the time or the bandwidth.

What the data says: most Americans aren't getting mental health support

I'm not alone. BetterHelp just released its State of Stigma report for 2026, and it reveals just where we truly stand when it comes to mental health care. Because while 85 percent of the 2,000 Americans surveyed say mental health care is a basic necessity, 78 percent of the respondents admitted they are not currently accessing mental health care.

This isn't a knowledge issue. In 2026, it's practically impossible to log on to social media, or even have an IRL conversation, without being exposed to ideas about mental health — from how prevalent issues like anxiety and depression are today to how life-changing proper mental health care can be.

The general public, particularly millennials and Gen Z, is incredibly therapy-aware. We have the tools to recognize that mental health issues don't discriminate, and the understanding that needing mental health care doesn't mean you're broken or damaged or unworthy.

The biggest barriers to therapy: cost, time, stigma, and skepticism

Yet the gap persists: Why are so many people avoiding the mental health care even they believe is so necessary?

According to the survey's findings, there are a few major barriers that stand in the way of people accessing therapy: Cost, time, skepticism, and fear of judgment.

I get it: I write about mental health, I encourage friends and family to seek out help, and I know many people who have benefitted immensely from therapy. I'm a major believer in the value of mental health care, yet I personally haven't seen a therapist in years.

Why time and cost aren't the only things keeping people from therapy

Like so many others (32 percent of the survey's respondents, to be exact), time is a real hurdle that keeps me from going to therapy regularly. I am a busy mom, a professional, and a caregiver for my aging parents. If I could create more hours in the day, I'm sure I'd use some of them towards seeking out mental health care…but unfortunately, that's simply not an option.

And then, of course, there's the cost piece: 52 percent of the people surveyed call this out as a barrier to accessing mental health care. This is real: Therapy is expensive, and under our current conditions (see: Economic instability, layoffs in every direction, an unemployment crisis), so many people lack the resources necessary to access proper mental health care.

The time and cost pieces of this conversation are fairly straightforward. It's relatively easy to understand that people don't always have the resources of time and money needed to access therapy. But those aren't the only factors at play here…and the more intangible parts of this conversation are just as important.

According to the survey, 32 percent of the respondents say skepticism is a barrier, while 27 percent call out stigma or fear of judgment as a reason for not utilizing mental health care.

Mental health stigma in 2026: Are we actually moving backward?

We've come a long, long way in our acceptance of mental health issues and normalization of all the tools people have at their disposal. But clearly, we still have a long way to go. If the findings are any indication, we may actually be moving in the wrong direction. 

The survey finds that a whopping 48 percent of Gen Z respondents are afraid of stigma around mental health (meanwhile, 34 percent of the people surveyed answered this way nationally), and 42 percent said they worry about being judged for seeking support. Destigmatizing mental health issues isn't a binary thing; there's a spectrum of total stigmatization and total acceptance, and it feels like we as a society are constantly moving along different parts of that spectrum.

And if I'm being honest, I understand the stigma piece too. I used to slip out of work without sharing that I was going to a therapy appointment. I guess a part of me felt like, as a high-achieving millennial woman, I should just be able to…handle the hard stuff. To power through. On some unconscious level, I think I feared that my anxiety would make people view me as someone who couldn't handle pressure, maybe even someone who wasn't cut out for success.

Of course, I had seen the advocacy around mental health awareness. I knew it was considered "okay not to be okay". But I still wasn't entirely comfortable with letting the world see the cracks in my armor…and that's what my anxiety had started to feel like.

Because here's the thing about destigmatizing mental health conditions: It doesn't happen overnight. It takes time and work to fully undo the belief that we have to handle our problems independently. And sometimes, as millennial and Gen Z women, we're so caught up with spreading awareness via our microphones, we forget to tell ourselves it's okay not to be okay.

Why millennials and Gen Z still feel pressure to handle mental health alone

According to BetterHelp's report, 47 percent of Millennials and 56 percent of Gen Z feel pressured to handle their mental health on their own, as compared to 39 percent of the general population. This stat stopped me in my tracks: Millennials and Gen Z are, by and large, the generations that are creating and spreading so many messages about the value of mental health care. Yet clearly, some of those messages aren't coming through internally quite yet.

Social media and mental health: a double-edged sword

Speaking of those messages: Let's talk about where they live. Mental health discourse is common on social media, and these platforms offer up great tools for us to open up important conversations about mental health and the treatments that can help people who are struggling. But the social media paradox is real: Gen Z in particular learns about mental health on social media, but 32 percent of people in this generation spend more than four hours on the apps each day. 

As we all know, social media can be a wonderful place to spread necessary messages about mental health…and it can also feed anxiety. And that's where so much of the tension lies: We use these digital tools to feel less alone, to spread and absorb messages that improve the collective mental health of our generations…at the same time, they can absolutely affect mental health in negative ways too. Finding that line between healthy and unhealthy social media use is nearly impossible, yet it's so crucial.

The internal stigmas we need to address

It's important that we don't just have these large-scale conversations about mental health care. It's also essential that we get honest with ourselves about the internalized stigmas we hold, the fear of judgment we carry, and the idea that we should be able to maintain our mental health without outside help — because those factors are barriers too, just like cost and time.

If cost, time, or logistics have kept you from getting support, BetterHelp offers accessible, affordable therapy you can do from wherever you are — no commute, no waiting room, no rearranging your whole day.

Want to dig deeper into the data? Read BetterHelp's full State of Stigma 2026 report to see what's really standing between Americans and the mental health care they need.