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Mental Health Care
Household Pulse Survey
To rapidly monitor recent changes in mental health care, the National Center for Health Statistics (NCHS) partnered with the Census Bureau on an experimental data system called the Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the impact of the coronavirus pandemic in the U.S. Data collection began on April 23, 2020.
Beginning in Phase 2, NCHS included questions about the impact of the coronavirus pandemic on mental health care. Estimates on this page are derived from the Household Pulse Survey and show the percentage of adults aged 18 and over who in the past four weeks a) took prescription medication for their mental health, b) received counseling or therapy from a mental health professional, or c) needed counseling or therapy from a mental health professional but did not get it (unmet mental health need). See the technical notes for more information on these measures. These questions were removed starting with Phase 3.5 of data collection.
Questions on the receipt of prescription medication, counseling or therapy, and unmet mental health need were included on the National Health Interview Survey (NHIS) in 2019. The NHIS, conducted by NCHS, is the major source for high-quality data used to monitor the nation’s health. Estimates of mental health care based on the 2019 NHIS may be useful benchmarks for comparison with estimates from the Household Pulse Survey. It is important to note that whereas the Household Pulse Survey asks about receipt of care in the past 4 weeks, the NHIS asks these questions with a 12-month reference period. In 2019, 15.8% of adults aged 18 and over took prescription medication for their mental health in the past year and 9.5% received counseling or therapy from a mental health professional in the past year (NCHS Data Brief 380). In 2019, 4.3% of adults aged ≥ 18 years did not receive counseling or therapy due to cost in the past 12 months.
Use the drop-down menus to show data for selected indicators or categories. Select the buttons at the bottom of the dashboard to view national and state estimates. The data table may be scrolled horizontally and vertically to view additional estimates.
Technical Notes
Survey Questions
At any time in the last 4 weeks, did you take prescription medication to help you with any emotions or with your concentration, behavior or mental health?
At any time in the last 4 weeks, did you receive counseling or therapy from a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker? Include counseling or therapy online or by phone.
At any time in the last 4 weeks, did you need counseling or therapy from a mental health professional, but did not get it for any reason?
Data Source
The U.S. Census Bureau, in collaboration with five federal agencies, launched the Household Pulse Survey to produce data on the social and economic impacts of Covid-19 on American households. The Household Pulse Survey was designed to gauge the impact of the pandemic on employment status, consumer spending, food security, housing, education disruptions, and dimensions of physical and mental wellness.
The survey was designed to meet the goal of accurate and timely weekly estimates. It was conducted by an internet questionnaire, with invitations to participate sent by email and text message. The sample frame is the Census Bureau Master Address File Data. Housing units linked to one or more email addresses or cell phone numbers were randomly selected to participate, and one respondent from each housing unit was selected to respond for him or herself. Estimates are weighted to adjust for nonresponse and to match Census Bureau estimates of the population by age, sex, race and ethnicity, and educational attainment. All estimates shown meet the NCHS Data Presentation Standards for Proportions.
Limitations
The Household Pulse Survey is different from other surveys. NCHS, the Census Bureau, and other federal statistical agencies are considered the preeminent source of the nation’s most important benchmark surveys. Many of these surveys have been in production for decades and provide valuable insight on health, social, and economic trends. However, the production of benchmark data requires a relatively long lead time, and personal interviews (face-to-face or telephone) require additional time. While efforts are underway to introduce COVID-19 questions into these surveys, that process can take months, sometimes years, before data are made available.
The Household Pulse Survey is different: It was designed to go into the field quickly, to be administered via the web, and to disseminate data in near real-time, providing data users with information they can use now to help ease the burden on American households and expedite post-pandemic recovery. The Census Bureau is fielding the Household Pulse Survey as a demonstration project, with data released as part of its Experimental Statistical Products Series.
Confidence intervals included in the tables on this page only reflect the potential for sampling error. Nonsampling errors can also occur and are more likely for surveys that are implemented quickly, achieve low response rates, and rely on online response. Nonsampling errors for the Household Pulse Survey may include:
- Measurement error: The respondent provides incorrect information, or an unclear survey question is misunderstood by the respondent. The Household Pulse Survey schedule offered only limited time for testing questions.
- Coverage error: Individuals who otherwise would have been included in the survey frame were missed. The Household Pulse Survey only recruited households for which an email address or cell phone number could be identified.
- Nonresponse error: Responses are not collected from all those in the sample or the respondent is unwilling to provide information. The response rate for the Household Pulse Survey was substantially lower than most federally sponsored surveys.
- Processing error: Forms may be lost, data may be incorrectly keyed, coded, or recoded. The real-time dissemination of the Household Pulse Survey provided limited time to identify and fix processing errors.
For more information on nonresponse bias for the 2020 Household Pulse Survey, please visit https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020_HPS_NR_Bias_Report-final.pdf.
For more information on the Household Pulse Survey, please visit https://www.census.gov/householdpulsedata.
Suggested Citation
National Center for Health Statistics. U.S. Census Bureau, Household Pulse Survey, 2020–2022. Mental Health Care. Generated interactively: from https://www.cdc.gov/nchs/covid19/pulse/mental-health-care.htm