Mental Health & Substance Abuse

The 13,100 mental health and substance abuse centers in the US provide treatment and care for patients with mental health disorders and substance abuse illnesses, also known as behavioral disorders. About 48% of outpatient service centers and 62% of residential treatment centers are non-profit organizations.

Dependence on Third Party Payers

Mental health and substance abuse centers rely primarily on insurance companies, managed care organizations, and government programs as their main sources of revenue.

Coverage Improving Via Parity Laws

Growing recognition of the cost of mental illness and lack of patient access to care has resulted in federal legislation to improve mental health and substance abuse coverage.

Sep 9, 2026 - Alcohol And Drug Use May Be Decreasing Among Young Americans

• The number of 12-to-17-year-olds who reported tobacco, illicit drug, and alcohol use and binge drinking in the past month decreased in 2025, according to a report from the federal Substance Abuse and Mental Health Services Administration. Meanwhile, 18-to-25-year-olds saw decreases in the use of nicotine products, tobacco, cigarette, alcohol and binge drinking in the past month as well as in the use of illicit drugs and prescription stimulants or opioids within the past year. American teenagers are engaging in less risky behavior such as crime, dangerous driving, and unprotected sexual behavior than previous generations, according to ABC News. With less risky behavior has come less substance use and abuse.
• Enrollment in Affordable Care Act (ACA) health insurance plans through Healthcare.gov has modestly decreased, according to the Washington Post. The ACA resulted in an extraordinary expansion of mental health and substance use disorder coverage, according to the National Alliance on Mental Illness. About 20 million people gained insurance coverage because of the ACA, including 15.3 million who became eligible for Medicaid. The ACA resulted specifically in significant reductions in the uninsured rate for individuals with mental health conditions and one study showed the share of people going without mental health care due to cost decreased by about one-third.
• All 50 states and the District of Columbia have seen fentanyl-related drug deaths decrease to levels not seen since 2020, according to an analysis of US overdose data conducted by researchers at the University of North Carolina at Chapel Hill. Demand for substance abuse treatment may decrease if the decrease in fentanyl-related drug deaths is due at least in part to a decrease in fentanyl use. "We are on track to return to levels of [fatal] overdose before fentanyl emerged," said Nabarun Dasgupta, lead researcher on the project which examined overdose records from the Centers for Disease Control and Prevention. Drug deaths in the US are down roughly a quarter, according to provisional Centers for Disease Control data. That includes fentanyl and other illicit drugs like cocaine and methamphetamine.
• Mental health and substance abuse industry employment increased slightly and wages for nonsupervisory employees decreased slightly during the first seven months of 2026, according to the US Bureau of Labor Statistics (BLS). Mental health and substance abuse treatment providers increased prices slightly during the first eight months of 2026, according to the BLS.

Industry size & Structure

A typical mental health or substance abuse center employs 42 workers and generates $4.2 million in annual revenue.

• The mental health and substance abuse service industry consists of about 13,100 companies that operate 23,000 facilities, employ about 546,000 workers, and generate $55 billion annually.
• About 48% of outpatient service centers and 62% of residential treatment centers are non-profit organizations.
• Large organizations include CRC Health Group and the Hazelden Betty Ford Foundation.