Americans See Opioids, Fentanyl As Top Threat, Mental Health Not Far Behind

Americans see poor mental health as one of the biggest threats to public health. This is especially true for young adults, who were twice as likely to identify it as the most pressing public health issue today. 

Even more pressing for Americans are opioids and fentanyl, which topped the list of most significant threats to public health in the Axios-Ipsos American Health Index. The poll also found that nine out of 10 Americans support health insurers covering mental health care on par with physical health care. 

The poll was based on a nationally representative sample of 1,247 adults and was conducted between Feb. 16 and 20.


Mental health is one of the “major causes of suffering in the U.S.,” and 17% of Americans believe it is the top threat to public health. Younger adults were more concerned than older adults, however. 

Among adults 18 to 29 years old, 22% identified mental health as the top concern, followed by 19% who saw opioids as more concerning.

Only 10% of people over the age of 65 saw mental health as the top public health threat.


Older adults were more likely to be concerned about the opioid epidemic. Opioids and fentanyl were ranked the overall top health threat, with 24% of respondents identifying these drugs as the most dangerous to public health.

Disparities existed across the political aisle, however, with Republicans being twice as likely as Democrats to identify opioids and fentanyl as the top threat.

The vast majority of Americans supported mental health parity, the poll found. Nine out of 10 respondents supported equal health insurance coverage for physical and mental health, with especially strong support from women, Black Americans, and Democrats.

These findings align with a survey by the Association for Behavioral Health and Wellness (ABHW), which found that 82% of Americans believe the health care system should treat behavioral and physical health equally. 

The ABHW survey found that, despite overall support for parity, only 39% of respondents said they would pay higher insurance costs for comprehensive behavioral health benefits.

The role of AI in behavioral health care

The Axios-Ipsos poll also found that while Americans are comfortable with some AI applications in health care, they remain wary of machine learning’s place in the doctor’s office.

Artificial intelligence (AI) is becoming increasingly commonplace in the behavioral health industry, generating attention and millions in funding.

Amwell launched a patient-therapist matching system that leverages AI to determine the patient’s need and improve patient activation.  

Mental health chatbots serve as “pocket pals” or help national health care systems triage patients for behavioral health care. 

Videra Health and Discovery Behavioral Health launched an AI-driven platform for SUD treatment follow-up that screens videos submitted by patients for signs of relapse. 

AI can save health care providers time and money, and Americans are fairly comfortable with some opportunities for AI integration in health care, like administrative tasks. Almost three-quarters said they were comfortable letting AI schedule appointments and more than half were comfortable letting it deliver test results, the poll found. 

People are less comfortable with AI’s involvement with more complex tasks, like asking basic health questions or helping a physician make a diagnosis. Just under half felt comfortable with AI’s participation in these procedures.

Only 16% of Americans were comfortable with AI making a diagnosis independently.

“There may be a place for AI in health care, but it’s still a little iffy for folks,” Mallory Newall, Ipsos vice president, said in a statement. “Doing the basics like scheduling appointments or some basic triage is OK, but anything beyond that is still a bridge too far for many Americans.”