Adults with intellectual and developmental disabilities (IDD), including conditions such as autism spectrum disorder and Down syndrome, face a disproportionately high burden of mental health challenges when compared to the general population. A recent comprehensive national survey study reveals alarming disparities in anxiety and depression prevalence, symptom severity, and access to appropriate mental health care services within this vulnerable population. Published in the prestigious journal JAMA Network Open, the study provides a critical glimpse into the systemic obstacles impeding effective mental health treatment and support for millions of Americans living with IDD.
This groundbreaking research leverages data collected from 2021 to 2023 through the National Health Interview Survey (NHIS), which is nationally representative across the United States, encompassing a broad and diverse demographic sample. From this dataset, researchers identified a sub-cohort of 796 adults with probable intellectual and developmental disabilities, extrapolating their representation to approximately 2.9 million Americans. By comparing this cohort’s mental health status and treatment access to that of over 43,000 adults in the general population, the study delineates stark contrasts in the prevalence and management of anxiety and depression.
The findings are profoundly concerning: adults with IDD are nearly nine times more likely to have been diagnosed with anxiety or depression than their general population counterparts. Specifically, rates of diagnosed anxiety and depression among the IDD cohort were approximately 57%, compared to just over 10% in the general adult population. Moreover, symptom frequency reveals that nearly half of individuals with IDD experience daily anxiety symptoms, a striking disparity compared to less than 8% in those without such disabilities. Daily depressive symptoms were also significantly more common, affecting nearly one in four individuals with IDD versus about 1% in the general population.
Despite the overwhelming mental health burden documented, only 40% of adults with IDD reported receiving counseling or psychotherapy within the past year, a figure that exposes a critical treatment gap. Instead, there appears to be a disproportionate reliance on psychiatric medications, with 40% and 37% using medication to manage anxiety and depression symptoms respectively during the same period. This overreliance on pharmacological treatment, without adequate complementary psychotherapy, underscores a vital mismatch between mental health care needs and available services tailored for the IDD population.
Financial barriers compound the challenges faced by these individuals. Study participants were five times more likely than those in the general population to delay therapy due to cost concerns and to forego mental health care altogether for financial reasons. Around 18% reported financial impediments preventing them from accessing essential mental health treatment. This is particularly disconcerting given that many adults with IDD benefit from Medicaid coverage, often a key safety net for health care access. The findings highlight significant out-of-pocket expenses and a scarcity of providers with both expertise and acceptance of insurance coverage for this demographic.
The study’s lead authors emphasize that insurance coverage alone does not guarantee sufficient mental health care access. Structural deficiencies in healthcare systems, including inadequate provider training, limited specialized services, and insufficient reimbursement rates for practitioners serving this group, contribute to persistent care disparities. Addressing these systemic issues is crucial to bridging the gap in mental health services for adults with intellectual and developmental disabilities.
Another important dimension highlighted is the premature mortality experienced by the IDD population. On average, individuals with intellectual disabilities have a lifespan reduced by 10 to 20 years compared to the general population. The exacerbation of mental health challenges and the insufficient management of these conditions further compound morbidity and mortality risks, intensifying the urgency for targeted intervention and systemic reform.
The research team urges policymakers to focus on strategies such as increasing Medicaid reimbursement rates for mental health clinicians specializing in IDD care, to incentivize more providers to enter this critical field. They also recommend integrating disability status into routine public health surveillance to better monitor trends and outcomes, leading to data-driven policy and programmatic responses. Furthermore, expanding formal training programs in disability-informed mental health care is fundamental to equipping clinicians with the skills necessary to deliver effective, empathetic, and individualized treatment.
Senior author Dr. Dimitri Christakis, a renowned pediatrician and researcher at the University of Washington School of Medicine, articulated the gravity of these findings, noting society’s historical neglect of mental health needs within the IDD population. “Our analysis paints a distressing picture — not only is mental illness more prevalent among adults with intellectual and developmental disabilities, but their access to appropriate treatment is profoundly inadequate,” Dr. Christakis stated. He emphasized that comprehensive reforms in health systems and insurance structures are imperative to alleviate these entrenched disparities.
The study draws attention to an often-overlooked mental health crisis in the United States. While public discourse frequently focuses on adolescent and young adult mental health challenges, this research highlights a parallel and equally urgent epidemic impacting individuals with intellectual and developmental disabilities. Raising awareness and prioritizing resource allocation for this underserved group must become a central component of national mental health policy.
Funding for the work was provided by the Special Olympics through grants from the Centers for Disease Control and Prevention and other philanthropic entities, underscoring the critical role of multidisciplinary partnerships in addressing complex health inequities. The involvement of Special Olympics also reaffirms the importance of community-based organizations in advocacy, research, and service delivery that align with the needs of people with disabilities.
This landmark study serves as a call to action for healthcare providers, policymakers, and society at large. It underscores that mental health treatment paradigms must be inclusive, adaptive, and adequately resourced to meet the needs of adults with intellectual and developmental disabilities. As the prevalence of diagnosed anxiety and depression continues to rise globally, ensuring equitable access and quality of care for vulnerable populations remains a paramount priority.
Subject of Research: People
Article Title: Anxiety, Depression, and Care Barriers in Adults With Intellectual and Developmental Deficits
News Publication Date: 20-Feb-2026
Web References:
10.1001/jamanetworkopen.2025.60205
Keywords: Developmental disabilities, Autism, Down syndrome, Anxiety, Depression, Mental health, Cognitive development, Health care costs, Clinical psychiatry
