JAMA Study: Severe Mental Health Disparities Found in IDD Adults

A study published in JAMA Network Open reveals a mental health crisis among US adults with intellectual and developmental disabilities (IDD), such as autism and Down syndrome. Investigators found this population experiences substantially greater rates of anxiety and depression compared to the general population, yet they face significant barriers to specialized care.^1,2

Using data from the 2021-2023 National Health Interview Survey, investigators evaluated a sample representing 2.9 million Americans with IDD. The findings revealed adults with IDD are 9 times more likely to report diagnosed anxiety (56.8% vs. 10.6%) and depression (56.9% vs. 9.9%) than their general-population peers. Symptom frequency is equally concerning, with 48.9% reporting daily anxiety and 24.2% experiencing daily depression.

For clinicians, the study highlights a critical gap in treatment modalities. While approximately 40% of the study population utilized psychiatric medication, only 40% had received counseling or psychotherapy in the past year. The investigators suggest these patterns indicate a concerning overreliance on medication over therapeutic intervention.

Barriers to care remain systemic. Patients with IDD were 5 times more likely to forgo care due to cost, a finding senior investigator Dimitri Christakis, MD, MPH, professor of pediatrics at the University of Washington and chief health office at Special Olympics International, noted is particularly striking given that many are covered by Medicaid. "Having insurance doesn't automatically translate to having access," Christakis stated, citing a lack of providers with the "appropriate expertise" to treat this demographic.

Estimates vary, but IDD prevalence make up 1.0% to 8.5% of the US population and the implications are life-altering, as adults with IDD currently face lifespans 10 to 20 years shorter than average. To address this, the investigators call for increased Medicaid reimbursement rates, the integration of disability status into public health surveillance, and the expansion of disability-informed training for mental health practitioners.

According to investigators, to quantify mental health disparities and access barriers with IDD patients by using nationally representative data. There were a few limitations which include identifying IDDs via functional criteria rather than clinical diagnoses, potentially missing milder cases and self-reported outcomes may be affected by recall bias and communication barriers.

Christakis has no relevant disclosures to report.

References:

1. Study: Anxiety, gloom often accompany intellectual deficits. EurekAlert! Published February 20, 2026. Accessed February 25, 2026. https://www.eurekalert.org/news-releases/1117193
2. Osuna AR, Kennedy J, Zhou C, Christakis DA. Anxiety, Depression, and Care Barriers in Adults With Intellectual and Developmental Disabilities. JAMA Netw Open. 2026;9(2):e2560205. doi:10.1001/jamanetworkopen.2025.60205