Watchdog group calls for accountability as mental health spending and treatment surge, including increased antidepressant use in youth, while outcomes continue to decline.
By Jan Eastgate
President CCHR International
April 3, 2026
The U.S. House Subcommittee on Health Care and Financial Services recently held a roundtable examining the state of mental health in America, revealing a troubling paradox: more Americans are seeking and receiving treatment than ever before, yet outcomes are significantly worsening. Spending on treatment for mental health and substance use disorders skyrocketed more than 241% from $40.9 billion in 2000 to $139.6 billion in 2021, according to a new Health Affairs study. Subcommittee Chairman Glenn Grothman (R-Wis.) noted that this massive increase is harming the economy while funding programs that fail to deliver results. Between 2002 and 2024, the number of adults receiving mental health treatment surged approximately 122% from about 27 million to nearly 60 million—far outpacing the U.S. population growth of only 18%. Depression rates have reached historic highs, and suicide rates have climbed back to levels not seen in decades.[1]
CCHR applauds the subcommittee’s initiative but emphasizes that the true costs—in both economic terms and lost lives—extend far beyond the figures available to the committee. In 2020, U.S. spending on behavioral health treatment—including mental health and substance use services—topped $280 billion.[2] In fiscal year 2022, $36.5 billion in federal and state funding was allocated to community mental health systems. Medicaid was the largest single funding source for community mental health at $24.7 billion, followed by state government funds at $8.1 billion.[3] In 2026, the federal government distributed $319 million specifically for community mental health services through its primary block grant program, part of nearly $800 million in total behavioral health block grant funding nationwide.[4] Such services generally rely upon the biomedical model, including psychotropic drugs, which have failed.[5]
The Congressional roundtable especially spotlighted how antidepressant prescriptions for individuals aged 12 to 25 rose more than 63% between 2016 and 2022, with over 221 million prescriptions dispensed to 18 million young people during that period. Yet outcomes continue to decline: in 2021, 57% of teen girls reported persistent feelings of sadness or hopelessness—up sharply from 36% a decade earlier.[6]
Chairman Grothman commented, “We are intervening more, medicating more, and spending more. Yet, many of the people we are trying to help are not getting better.”
CCHR obtained prescription data from IQVia’s Total Patient Tracker, which shows that in 2020 alone, over 76 million Americans, including 6.1 million children and teens—hundreds of thousands under the age of five—were prescribed psychotropic drugs.[7]
Between 1999 and 2019, these drugs were reported as contributing to 51,446 deaths and nearly 650,000 overdoses, with the annual death rate more than tripling.[8]
Additionally, approximately 1.2 million people are involuntarily hospitalized each year for psychiatric treatment they do not want. The coercion can prove lethal: a July 2025 Federal Reserve Bank of New York study found that individuals involuntarily hospitalized were nearly twice as likely to die by suicide or overdose within three months of release.[9]
The same study reported that treatment costs could reach as high as $14,000 per person per year in Medicaid behavioral health spending. Medicaid is the primary payer for mental health and substance abuse treatment. In 2019, the agency spent more than $75 billion on mental health and substance use care, with almost 43% directed toward individuals younger than 20 years of age. Of the $43.2 billion spent nationwide on inpatient mental health and substance use treatment, nearly half ($19.3 billion) came from Medicaid, compared with $6.8 billion from Medicare, $16.2 billion from commercial insurance, and $880 million from out-of-pocket spending by individuals.[10] More than $6 billion was spent on antipsychotics, representing 9% of Medicaid’s total prescription costs.[11]
Hundreds of billions of taxpayer dollars are being poured into psychiatric treatment, including drugs and brain-damaging electroshock treatment, yet we see only poor or worsening results.
For over three decades, CCHR has exposed billions in wasted taxpayer dollars funneled through the National Institute of Mental Health (NIMH) for behavioral research, including studies on whiptail lizards, insects, electric fish, and bird “vocal learning.”[12] Over a 13-year period, NIMH spent $20 billion on mental health research. Former NIMH director Dr. Thomas Insel acknowledged the agency’s shortcomings and failures, stating that despite leading the world in medical research spending, the U.S. has “dismal outcomes” and failed to “move the needle” on reducing suicide, hospitalizations, or fostering recovery. Insel noted that mental health trends are moving in the wrong direction—unlike progress seen in cancer survival, heart disease, or diabetes.[13]
Dr. David Hyman, adjunct scholar at the Cato Institute and Professor of Health Law & Policy at Georgetown Law, addressed the Congressional roundtable about the systemic fraud. He pointed out that spending on mental health and substance use disorders has grown faster than overall healthcare expenditure, now accounting for roughly 5% of total U.S. healthcare spending. “When we pay for services, we get services; we don’t necessarily get better mental health,” Hyman said, citing “misaligned incentives” and the lack of reliable measures of effectiveness. He described mental health as a “fraud-laced industry” where billing for services not performed and falsified records remain prevalent.[14]
Dr. Hyman also quoted the 2014 Inspector General for the Department of Health and Human Services, Richard Kusserow, who isolated mental health as a special enforcement problem that stretched back decades. Kusserow stated that psychiatrists and psychologists “have the worst fraud record of all medical disciplines.”[15] If you look at the providers that have been excluded from the Medicare and Medicaid programs, Dr. Hyman continued, “psychiatrists punch well above their weight in terms of their likelihood of being excluded from the program” for engaging in a “variety of these frauds.”
CCHR has long tracked mental health fraud schemes, which have ranked among the top crimes committed in the mental health industry. A 2020 study in the Journal of Medical Economics described a typical fraudster as a 53-year-old male psychiatrist who overbilled federal insurance programs for unperformed services or inflated session times. Thousands of patients, including children, are hospitalized unnecessarily and held until their insurance benefits expire in order to fill beds.[16]
The rise of telepsychiatry has also exacerbated the problem, with more than 20 states flagging fraud, waste, and abuse concerns in behavioral telehealth services.[17]
Unless the mental health industry’s results are rigorously measured and held accountable, the abusive and unworkable practices driving today’s declining conditions will persist. Real reform must begin by ending coercive psychiatric practices that force taxpayers to fund unwanted treatments with no guaranteed benefit—and with reported worsening of mental states. It must require comprehensive physical examinations before any psychiatric diagnosis or prescription. And it must direct funding exclusively toward proven, workable solutions that deliver genuine cures rather than endless intervention. Above all, there must be full accountability for every dollar spent.
[1] Glenn Grothman, “Grothman Opens Roundtable on Examining Mental Health in the MAHA Age,” U.S. Committee on Oversight, Subcommittee on Health Care and Financial Services Chairman, 26 Mar. 2026, https://oversight.house.gov/release/grothman-opens-roundtable-on-examining-mental-health-in-the-maha-age/, citing Tami L. Mark, Lasanthi Fernando, Peter Shieh, and Abe Dunn, “US National Spending On Mental Health And Substance Use Disorder Treatment Driven By Case Growth, 2000–21,” Health Affairs, 18 Mar. 2026, https://www.healthaffairs.org/doi/10.1377/hlthaff.2025.01351
[2] New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA), “U.S. Spending on Behavioral Health Topped $280 Billion in 2020,” 8 Aug. 2024, https://www.njamhaa.org/2024-08-08-us-spending-on-behavioral-health-topped-280-billion-in-2020
[3] “Organization & Funding of Community Mental Health,” 2023-2024, NRI, Nov. 2024
[4] SAMHSA, “SAMHSA Distributes Nearly $800 Million in Block Grants Nationwide,” U.S. Department of Health and Human Services, 4 Feb. 2026, https://www.samhsa.gov/newsroom/press-announcements/20260204/samhsa-distributes-nearly-800-million-block-grants-nationwide-community-based-mental-health-substance-abuse-programs
[5] Jeff Goldsmith, “A Failed Revolution In Mental Health,” Health Affairs, Jan 2020, https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01609
[6] Glenn Grothman, “Grothman Opens Roundtable on Examining Mental Health in the MAHA Age,” U.S. Committee on Oversight, Subcommittee on Health Care and Financial Services Chairman, 26 Mar. 2026, https://oversight.house.gov/release/grothman-opens-roundtable-on-examining-mental-health-in-the-maha-age/
[7] https://www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/; https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/
[8] Mike Vuolo, “Trends in Psychotropic-Drug-Implicated Mortality: Psychotropic Drugs as a Contributing But Non-Underlying Cause of Death,” Drug Alcohol Depend, 24, June 2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC8355085/
[9] Natalia Emanuel, et al. “A Danger to Self and Others: Health and Criminal Consequences of Involuntary Hospitalization,” Federal Reserve Bank of New York Staff Reports, no. 1158, July 2025, https://www.newyorkfed.org/medialibrary/media/research/staff_reports/sr1158.pdf?sc_lang=en
[10] “Medicaid’s Role in Mental Health and Substance Use Care,” The Commonwealth Fund, 7 May 2025, https://www.commonwealthfund.org/publications/explainer/2025/may/medicaids-role-mental-health-and-substance-use-care
[11] “Descriptive Trends in Medicaid Antipsychotic Prescription Claims and Expenditures, 2016 – 2021,” The Jour. of Behavioral Health Services and Research, 10 July 2024, https://link.springer.com/article/10.1007/s11414-024-09889-0
[12] CCHR International,“$280B Invested, Mental Health Worsens—CCHR Demands Audit and Accountability,” cchrint.org, 22 Nov. 2024, https://www.cchrint.org/2024/11/22/280b-invested-mental-health-worsens-cchr-demands-audit-and-accountability/
[13] Dr. Stanton Peele, “How American Psychiatry Misled the World and Ruined Mental Health Worldwide,” Life Progress Plan, 2 Oct. 2023, https://lifeprocessprogram.com/american-psychiatry-misled-the-world/; Gregg Henriques Ph.D., “Twenty Billion Fails to ‘Move the Needle’ on Mental Illness,” Psychology Today, 23 May 2017, https://www.psychologytoday.com/us/blog/theory-of-knowledge/201705/twenty-billion-fails-to-move-the-needle-on-mental-illness
[14] “Hidden crisis in US mental health: Why depression and suicide rates are increasing,” Mathrubhumi.com, 30 Mar. 2026, https://english.mathrubhumi.com/lifestyle/health/us-mental-health-crisis-treatment-outcomes-e3leacfz
[15] Richard P. Kusserow, “Mental Health Ranks High on Fraud Scale,” Walters Kluwer, 23 Sept. 2014, https://groups.google.com/g/alt.health/c/lwN0yWnF5uE
[16] Yuriv Timofeyev, Mihajilo Jakovljevic, “Fraudster’s and victims’ profiles and loss predictors’ hierarchy in the mental healthcare industry in the US,” Journal of Medical Economics, Vol 23, Issue 10, 12 Aug. 2020, https://www.tandfonline.com/doi/full/10.1080/13696998.2020.1801454
[17] https://www.cchrint.org/2023/02/17/20-billion-in-psychiatric-fraud/; Anuja Vaidya, “Fraud Enforcement Followed Spike in Telemental Care,” Informa TechTarget, 24 Nov. 2021, https://mhealthintelligence.com/news/fraud-enforcement-followed-spike-in-telemental-care
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