Where is the Mental Health Crisis Heading in 2025? Hear from Experts

“We are in a mental health crisis.”

The statement above has been scattered across the US, spotlighted in headlines, and is a concern for many mental health advocates. However, what does this crisis mean, and why are we in a mental health crisis now?

As experts alluded to, this is not so much of a new crisis but rather a spotlight on the already existing, and continuously rising, mental health issues. We could blame the pandemic as reports of mental illness skyrocketed in recent years, but mental health issues stretched years before.

“I think it's become popular to talk about there being a crisis,” Steve Levine, MD, from Compass Pathways, told HCPLive. “Everything these days seems to be a crisis, which is excellent fodder for headlines in the news. My sense of things, and perhaps it's an ignorant one, is that we haven't necessarily fallen off a cliff, but that this has been progressive as a society. We’ve continued to get unhealthier.”

Levine added that, although people live longer and are healthier relative to 50 or 100 years, that does not necessarily mean they live healthier lives. About 75% of Americans are either overweight or obese, which may raise the risk of many conditions, such as cardiovascular disease and diabetes.1,2,3 The global pandemic added stress to the system and further widened disparities in healthcare access.

“I don't know that this is a discrete moment in time, so much as the accumulation of ineffective responses to an increasingly unhealthy society,” Levine said.

Until recently, mental health education lagged, with the priority on physical health. With mental health garnering more attention, more people are seeking mental health care and reporting psychiatric symptoms.

A 2019 study using the National Survey on Drug Use and Health discovered a 52% increase in reporting depression-related symptoms in the last 12 months from 2005 to 2017 among adolescents (from 8.7% to 13.2%).4 The study also saw a 63% increase in young adults reporting depression symptoms from 2009 – 2017. The study's lead investigator said in a press release that the cultural trends in the last decade, such as the increase in digital media, may have a larger psychological impact on younger generations than older generations.5

Although more people are now reporting depression symptoms than in the late 2000s, that does not necessarily mean that more people now have mental health issues.

“It's like when people say that the LGBTQ+ community didn't exist hundreds of years ago—people have existed,” said Emma Wille, MS, healthcare analyst at Citeline. “We just did not find them, and they did not feel comfortable being in the open, and I think [it’s] the same as mental health.”

Mental health concerns date back to the colonial period when people presenting psychiatric symptoms were treated with straightjackets and social isolation in mental asylums.6 With continuous mental health concerns throughout history, there is no clear line as to when the mental health crisis began.

The COVID-19 pandemic, although not the leading cause of the crisis, re-opened the conversation about mental health. In December 2021, the US Surgeon General warned about the “devastating” mental health of young people, and the House of Representatives officially declared a mental health crisis among children and adolescents in the US on May 22, 2023.7,8 The Biden-Harris recently made efforts to fight the mental health crisis, awarding $127.7 million in September 2023 to expand certified community behavioral clinics across the US.9

In an interview with HCPLive, Leanna Fortunato, PhD, the director of quality and innovation at the American Psychological Association, said some of the contributing factors of the current mental health crisis were the combination of greater attention on mental health, social change in the past decade with 24/7 media access, and high rates of loneliness.

“Historically, we've tended to think of physical health and mental health as very separate, and so certainly in the healthcare industry, they've been treated very differently,” Fortunato said. “[With] the rise of the 24/7 media cycle, it's exposing people to a lot more stress than they were exposed to before…All of these different pieces have come together to really shine a light on this area of mental health that maybe hasn't been as much of a focus in generations past."

Projection of Depression Drug Sales

Medication costs could have an impact on the mental health crisis. New drugs tend to be more expensive, so patients may opt to continue taking cheaper medication and struggle with their symptoms. For instance, esketamine (Spravato), approved in 2019, costs $40,000 a year without insurance due to development costs, according to Wille.

“It’s hard to get insurance companies to want to cover these drugs because there is a whole pool of generic SSRIs, like Lexapro or Prozac, that are just sitting there available for pennies,” Wille said.

Depression drug sales are projected to reach 16.5 billion by 2030, representing a compound annual growth of 18.8% from 2023 to 2030, according to data from Evaulate Pharma10 Wille explained the projected increase in sales is due to a rise in depression, the patient population, and the expensive novel drugs in the pipeline, such as psychedelics.

To fight the mental health crisis, Wille emphasized the need for work on improving care access and reducing the mental health stigma. People’s financial situation may prohibit them from obtaining care even with insurance.

“We find ourselves in a situation where the gaps between people who can afford to do things like go to therapy and take antidepressants and the people who cannot are widening by the year,” Wille said.

What’s Moving in the Psychiatry Pipeline

More than 300 new drugs for depression are in the pipeline, with 163 drugs from filed phase 1 trials, according to Datamonitor and Biomedtracker, the data provided by Wille. Many novel therapies are on the horizon, with Lykos Therapeutics working on MDMA-assisted therapy to treat PTSD, Johns Hopkins Center studying mental health treatments with psilocybin, and the University of California San Francisco studying psilocybin therapy for depression in Parkinson Disease.11,12

Aside from psychedelics, lumateperone (CAPLYTA), an oral, once-daily atypical antipsychotic, is estimated to be approved in 2025 for Major Depressive Disorder (MDD).13 Intra-Cellular Therapies announced on December 3, 2024, that they submitted their supplemental New Drug Application (sNDA) to the US Food and Drug Administration (FDA) for lumateperone (CAPLYTA) as an adjunctive therapy to antidepressants.

Additional depression drugs in the pipeline include COMP360 (estimated approval: late 2027, early 2028) CYB003 (estimated: 2028), aticaprant (estimated: 2026), navacaprant (NMRA-140) (estimated: 2026), seltorexant (estimated: 2027), REL-1017 (estimated: 2026). Ruoxinlin (ansofaxine/LY03005) is also awaiting a decision; the FDA accepted the NDA in March 2020 but has not provided an update since.

The Direction of the Mental Health Crisis in 2025

Although the psychiatry pipeline has many promising drugs, the mental health crisis will not go away in one sweep.

Fortunato predicts that in 2025 we will continue to use telehealth, integrate mental health at the primary care level, and further develop digital therapeutics.

“To make a dent in the mental health crisis, we want to start further upstream,” Fortunato said. “We want to be catching people either in the very early stages of developing a mental health concern or even before they develop a mental health concern.”

Healthy lifestyle choices, such as a balanced diet, good sleep, exercise, and avoiding tobacco products or alcohol are just as good for mental health as physical health. Mental health education can also prevent the development of mental health issues. Studies have shown implementing mental health programs in schools has helped children develop skills in emotion regulation, stress management, and the ability to identify emotions.

Experts emphasize the importance of mental health—health is health, whether that be psychological or physical—and should be addressed just as regularly.

“Every day is mental health awareness day,” Maria Oquendo, MD, PhD, from Penn Medicine, had said back in May during the American Psychiatric Association’s 2024 Annual Meeting in New York.14 “The pandemic has brought us many negative things, but a positive thing is that there is broad awareness amongst the public, and in the house of medicine, of the importance of mental health. The reality is there is no health without mental health.”

References:

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2. Campbell, P. Obesity-Related Heart Disease Deaths Rose Roughly 180% Since 1999. HCPLive. November 17, 2024. https://www.hcplive.com/view/obesity-related-heart-disease-deaths-rose-roughly-180-since-1999. Accessed December 5, 2024
3. Campbell, P. More than 60% with Type 1 Diabetes Also Dealing with Overweight or Obesity, Study Finds. HCPLive. February 14, 2023. https://www.hcplive.com/view/type-1-diabetes-overweight-or-obesity-study-finds. Accessed December 5, 2024.
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8. H.Res.434 - Declaring a mental health crisis among youth in the United States, and expressing the pressing need for historic investments in mental health care for students. Congress.gov. May 5, 2023. https://www.congress.gov/bill/118th-congress/house-resolution/434/text. Accessed December 5, 2024.
9. Approaching 60th Anniversary of Community Mental Health Act of 1963, the Biden-Harris Administration Awards Nearly $130 Million to Expand Certified Community Behavioral Health Clinics Across US. Substance Abuse and Mental Health Services Administration. September 21, 2023. https://www.samhsa.gov/newsroom/press-announcements/20230921/biden-harris-administration-awards-grants-to-expand-certified-community-behavioral-health-clinics-across-united-states#:~:text=The%20Community%20Mental%20Health%20Act%20of%201963%2C%20passed%20as%20part,for%20people%20with%20mental%20illness. Accessed December 5, 2024.
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