One in five adults — or roughly 600,000 Iowans — live with some form of mental illness, yet a study finds tens of thousands have had no treatment.

Paul Gionfriddo, president of Mental Health America, says it’s important that mental health services and treatments be made readily available and more accessible, especially in rural states like Iowa.

“On average, it typically takes almost a decade, about 10 years from the time of onset of symptoms to the time people get appropriate treatment for any mental illness,” Gionfriddo says. “A lot of adults report they just don’t have access to care. Often, that’s because there is no access in those states or there isn’t the right kind of coverage that people have.”

According to the report, 50% of teenagers often think about suicide or self-harm throughout the week, while 76% of youth with severe depression don’t get the treatment they need.

It’s vital to think of mental illness in terms of the “Before Stage 4” philosophy, he says, that mental health conditions should be treated long before they reach the most critical points.

“It’s a real problem when we wait so long because we lose opportunities to intervene effectively,” Gionfriddo says. “By applying a danger-to-self or other standard, we make mental illnesses the only chronic diseases in America that we wait until stage four to treat, and then, often inappropriately only through incarceration.”

Mental health screenings should be as common for adults as getting one’s blood pressure tested, or for kids, as often as they get eyesight or hearing tests. Screenings are particularly important for youth, he says.

“Half of mental illnesses emerge by the age of 14, three-quarters by the age of 25,” Gionfriddo says. “The last symptoms that emerge are behavioral symptoms. Way before then, children are reporting feeling depressed, having trouble sleeping, having trouble eating, and all other kinds of conditions we need to be aware of, we need to think about and we need to intervene about.”

Overall, the State of Mental Health in America 2018 Report finds 43-million Americans have a mental health condition, yet 57% of American adults have not received treatment. Free mental health screenings are available at