Majorities of U.S. adults who needed care cited difficulties getting it, including those who did receive care. The primary barriers to access for those with unmet needs for substance use or mental health challenges over the past 12 months include cost-related issues (no insurance, out-of-pocket costs, 31 percent and 37 percent, respectively), the inability to find a conveniently located provider (22 percent and 28 percent, respectively) and the inability to get an appointment immediately when they needed care (31 percent and 25 percent, respectively).