American adults are feeling less positive about their psychological well-being than at any point in the last two decades. A new report indicates that the percentage of United States adults who consider their mental health to be top-tier has fallen below a specific threshold for the first time on record. These figures come from a recent survey conducted and released by Gallup.

Background and Context

Public health researchers monitor self-reported health data to identify shifts in societal well-being that clinical data alone might miss. Subjective assessments provide early indicators of broader changes in healthcare demand, economic productivity, and social cohesion. For nearly twenty years, these specific metrics regarding how Americans view their own minds remained notably consistent.

From 2001 through 2019, the national mood appeared stable in aggregate. During that extended period, at least 42 percent of respondents consistently rated their mental health as “excellent.” This baseline suggested a certain resilience or steadiness in the American public’s psychological state, regardless of economic cycles or political shifts.

The arrival of the COVID-19 pandemic introduced a massive variable into this stability. Researchers aimed to determine if the initial shock of the global health crisis created a temporary dip or a lasting alteration in the national psyche. The study seeks to measure the persistence of these effects five years after the onset of the pandemic. It also aims to pinpoint which specific demographic groups bear the heaviest burden of this psychological shift.

Study Methodology

The researchers gathered data through telephone interviews conducted in November 2025. The sample consisted of over 1,300 adults aged 18 and older, living across all 50 U.S. states and the District of Columbia. To ensure the findings accurately reflected the national population, the team used random digit dial methods to reach both landline and cellphone users.

The analysts then weighted the collected samples to correct for potential selection biases. They matched the data to national demographics including gender, age, race, Hispanic ethnicity, education, region, and population density. This process ensures that the views of specific groups are not overrepresented or underrepresented in the final statistics.

Findings on Mental Well-Being

The primary discovery is a continuing erosion of mental well-being across the country. Only 29 percent of adults now describe their mental health as “excellent.” This figure sits below the 30 percent mark for the first time in the survey’s history. Just six years prior, before the pandemic began, 43 percent of respondents gave themselves this top rating.

When combining those who feel “excellent” with those who feel “good,” the total is 72 percent. This combined number also represents a new low point, dropping by three percentage points from previous measurements. The data suggests that the pandemic acted as a distinct pivot point. By November 2020, roughly eight months into the health crisis, the “excellent” rating had already tumbled nine points to 34 percent.

The decline appears across almost all major demographic subgroups. However, the intensity of this drop varies by age and education. Younger generations serve as the primary drivers of this downward trend. Over the past six years, adults belonging to Generation Z and the millennial generation saw their “excellent” ratings drop by approximately 15 percentage points each.

Currently, only about 23 percent of Gen Z adults view their mental health as excellent. Millennials track closely behind at 28 percent. This stands in distinct contrast to older cohorts. No less than 34 percent of adults in Generation X, the baby boomer generation, or the Silent Generation rate their mental health as excellent.

Education levels also play a substantial role in these changing perceptions, though perhaps not in the way one might expect. Historically, college graduates reported substantially better mental health than non-graduates.

That gap has largely vanished in recent years. Graduates saw a 17-point drop in excellent ratings since the 2014-2019 period. This steep decline has brought their self-assessments much closer to the levels reported by those without degrees, who experienced a smaller 10-point decline.

The study found that men and women experienced similar declines in their mental health assessments. However, racial groups did not share this trajectory equally. White and Black Americans reported steeper drops in well-being compared to Hispanic Americans. Political affiliation also correlated with the results, with Democrats reporting a smaller decrease in mental health ratings than Republicans or independents.

Trends in Seeking Treatment

As self-assessment worsens, reliance on professional help has risen. The survey indicates that 24 percent of U.S. adults visited a mental health professional in the past year. This includes 8 percent who attended more than ten sessions. On average, adults now report 3.2 visits per year. This represents a steep increase from the 1.1 visits average recorded in 2001 and 1.5 in 2004.

Younger generations are utilizing these services at much higher rates. Thirty-six percent of Gen Z adults and 29 percent of millennials visited a professional in the past year. This rate is significantly higher than that of older groups; only 14 percent of baby boomers and 7 percent of the Silent Generation reported similar visits. Gen Z and millennial adults now average over four mental health visits annually, more than double the rate of their older counterparts.

This increase in treatment seeking may reflect a cultural shift as well as a rise in distress. Younger adults have matured in an era where mental health struggles are acknowledged more openly. Medical communities and employers place greater emphasis on emotional well-being than in previous decades. This environment may make younger Americans more comfortable admitting their mental health is subpar and seeking assistance.

Physical Health Remains Stable

The survey highlights a sharp divergence between physical and mental health trends. While mental well-being metrics plummeted, physical health ratings remained fairly consistent. About 25 percent of adults describe their physical health as excellent. This is only a slight dip from the 29 percent average seen during the 2014-2019 period.

When looking at the combined “excellent” and “good” ratings for physical health, the number sits at 77 percent. This is largely similar to where the metric has hovered for the past 25 years. This stability suggests that the current crisis in well-being is primarily psychological rather than physiological.

An inverse relationship exists regarding age. Older Americans generally rate their mental health higher than younger groups. However, the pattern flips for physical health. Younger adults consistently rate their physical bodies better than older generations do. Thirty-six percent of Gen Z adults describe their physical health as excellent, compared to just 16 percent of the Silent Generation.

Medical Visits and Trust

Americans continue to visit medical doctors for physical ailments at steady rates. The average adult visited a medical doctor 5.3 times in the past year. This frequency is similar to the 4.7 visits measured in 2001. Routine preventative care also remains common, with 76 percent of adults reporting they had a routine checkup in the past year.

While attendance is stable, trust in medical advice shows signs of erosion. Sixty-three percent of adults feel confident in the accuracy of their doctor’s advice without needing a second opinion. This is lower than the 70 percent trust level seen in 2010. Roughly one-third of the population now feels it is necessary to check for second opinions or conduct their own research.

Age influences this trust level heavily. Older adults represent the most trusting cohort, with 77 percent expressing confidence in their physicians. In contrast, trust drops to 67 percent among those aged 50 to 64. It falls further to below 60 percent for adults under age 50.

Political divides persist in the medical realm as well. Democrats express confidence in their doctors’ advice at a rate of 74 percent. This is notably higher than Republicans at 62 percent and independents at 57 percent. These partisan gaps have remained relatively consistent over the last few years.

Financial Anxieties

The data tables accompanying the report reveal that economic concerns related to healthcare remain prevalent. Forty-seven percent of respondents classify not having enough money to pay for medical care as a major concern. This anxiety is not distributed evenly. Lower-income households express significantly higher levels of worry regarding healthcare affordability.

Additionally, fear regarding insurance coverage persists. Forty-one percent of adults worry that they or a family member will be denied coverage for a pre-existing condition. Another 43 percent worry about going without health insurance entirely at some point. These financial stressors provide a backdrop to the broader findings on health and well-being.

The report concludes that while Americans are maintaining their physical health routines, their psychological state has undergone a profound shift. The stability that characterized the early 21st century has dissolved. It has been replaced by a landscape where younger, educated adults report struggling the most, even as they engage more frequently with mental healthcare providers.