Our work shaping and reporting on national mental health policy is made possible through a capacity grant from the Perigee Fund.
The Substance Abuse and Mental Health Services Administration’s 2024 National Survey on Drug Use and Health (NSDUH) and the Trust for America’s Health’s Pain in the Nation 2025: The Epidemics of Alcohol, Drug, and Suicide Deaths shed light on the broader behavioral health landscape impacting the U.S., including women of reproductive age. While neither report includes pregnancy-specific data, their findings reveal urgent implications for maternal mental health.
Mental Health Conditions Are Widespread, and Treatment Lags
NSDUH data shows 1 in 4 adults experienced any mental illness (AMI) in 2024 and treatment gaps remain vast. Nearly 48% of those with AMI, and 30% of those with serious mental illness (SMI), did not receive mental health services in the past year. These treatment gaps likely disproportionately affect pregnant and postpartum individuals, underscoring the urgency to embed mental health screenings into prenatal care.
Co-Occurring Mental Health Conditions and Substance Use Disorders Are Common and Often Go Untreated
For both adults and adolescents with mental health challenges, the prevalence of substance use is higher compared to those without mental health challenges. Among adults with SMI in 2024, almost 47.3% also had a substance use disorder (SUD), and 34.5% of adults with AMI had co-occurring SUD. Alarmingly, 41.2% of adults with both AMI and SUD received no treatment at all, while only 14.5% received services for both conditions. For new and expecting mothers, integrated care is critical to prevent exacerbation of mental health risks.
Young Adults Face the Steepest Barriers
Young adults aged 18–25 have the highest prevalence of AMI and SMI: 33.8% and 10.3%, respectively, compared to older age groups. Yet, nearly 30% of this group received no behavioral health services at all. This demographic should be a central focus in any maternal mental health strategy.
National Mortality Trends Signal Broader Risks
The Pain in the Nation report notes that over 200,000 Americans died from alcohol, drug overdose, or suicide in 2023, double the rate two decades prior. Though overdose deaths declined 4% in 2023 and show signs of a dramatic 27% provisional drop in 2024, inequities persist. Only white Americans saw statistically significant improvements, while overdose rates stayed highest among American Indian/Alaska Native, Black, and adults aged 35–54. Addressing these disparities requires a targeted maternal mental health strategy that integrates substance use prevention, treatment, and culturally responsive care to improve outcomes for women in marginalized communities.
Suicide Risk in the Perinatal Period
Suicide is a leading cause of death during the perinatal period, yet it remains under-addressed in maternal care. According to NSDUH, 12.2% of young adults (ages 18–25), a key reproductive age group, had serious thoughts of suicide in the past year, and 2.0% attempted suicide, underscoring the urgency of screening during and after pregnancy. The Pain in the Nation report adds that 49,316 people died by suicide in 2023, with the highest rates among American Indian/Alaska Native populations and young adults. While men die by suicide at higher rates, women, especially young women, are more likely to attempt it, often through less lethal means that still reflect serious mental health distress. Together, these findings highlight the need to integrate suicide risk screening and prevention into all stages of perinatal care, not just for depression and anxiety, but as a core part of the maternal mental health response.
Where We Go From Here: A Call to Action
The data in these national reports make clear that mental health, substance use, and suicide are not isolated crises. They are overlapping and intensifying challenges with direct implications for maternal health. Efforts to improve perinatal care should include comprehensive screening for mental health and substance use disorders, integrated treatment models, and culturally responsive care that prioritizes equity. Only by addressing these interconnected issues head-on can we hope to improve outcomes for mothers, babies, and families across the country.
