Only 23% of U.S. adults used telehealth for mental health in 2022, yet 45% say they are open to digital mental health tools in 2024. At the same time, getting help is uneven, with 18.3% of adults with mental illness reporting they did not receive mental health services in the past year and about one in four adults still relying on counseling or therapy. Put these gaps beside relationship skills outcomes from couple and dating violence prevention studies, and the difference between intention and support becomes hard to ignore.
Key Takeaways
- 3.9% of U.S. adults had an opioid use disorder in 2022
- 23.1% of U.S. adults reported they are currently in a romantic relationship (married, living with partner, or dating) in 2023
- 9.9% of U.S. adults reported experiencing serious psychological distress (psychological distress) in the past 30 days in 2023
- 23% of U.S. adults used telehealth for mental health in 2022 (survey estimate)
- 45% of U.S. adults said they are open to using digital tools (apps or websites) to improve mental health in 2024 (APA survey)
- 1 in 4 adults (25%) in the U.S. reported receiving some form of counseling or therapy for mental health in 2021 (NSDUH)
- 2-point improvement in relationship satisfaction score after 12 sessions of cognitive behavioral therapy for couples (meta-analysis effect size)
- Approximately 70% of couples treated with evidence-based couple therapy show clinically significant improvement (peer-reviewed review, 2018)
- Effect sizes for couple therapy interventions average around d≈0.5 for relationship distress (systematic review meta-analysis)
- U.S. behavioral health telehealth utilization increased substantially during 2020–2021, with video-based mental health visits rising by hundreds of percent from pre-pandemic baselines (HHS/ASPE summary)
- The U.S. market for digital mental health was valued at $4.6 billion in 2020 and projected to reach $28.3 billion by 2027 (global digital mental health market sizing estimate)
- In 2023, the global online therapy market was estimated at $4.7 billion and projected to grow to about $16.8 billion by 2030 (market forecast estimate)
- In 2022, the average per-session cost of couples therapy in the U.S. ranged between about $100 and $300 per session (cost estimate survey/market report)
- In 2022, domestic violence-related emergency shelter costs in the U.S. totaled $1.6 billion (federal/state program spending estimate)
- In 2023, the U.S. federal budget for domestic violence prevention and services included about $1.6 billion in mandatory and discretionary funding (HHS/ACF budget summary)
Many Americans lack mental health and substance care, but counseling and evidence based relationship programs show measurable improvements.
Related reading
01 · Category
Population Prevalence4 stats
01
3.9% of U.S. adults had an opioid use disorder in 2022
02
23.1% of U.S. adults reported they are currently in a romantic relationship (married, living with partner, or dating) in 2023
03
9.9% of U.S. adults reported experiencing serious psychological distress (psychological distress) in the past 30 days in 2023
04
1 in 10 (10.0%) people ages 18–24 in the U.S. experienced dating violence in the past 12 months in 2022
Interpretation
Population Prevalence Interpretation
From a population prevalence perspective, Healthy Relationships coexist with major risk factors and relationship harms, since only 23.1% of U.S. adults report being in a romantic relationship while 3.9% have an opioid use disorder, 9.9% report serious psychological distress, and 10.0% of 18 to 24 year olds experience dating violence.
02 · Category
User Adoption6 stats
01
23% of U.S. adults used telehealth for mental health in 2022 (survey estimate)
02
45% of U.S. adults said they are open to using digital tools (apps or websites) to improve mental health in 2024 (APA survey)
03
1 in 4 adults (25%) in the U.S. reported receiving some form of counseling or therapy for mental health in 2021 (NSDUH)
04
10.2 million U.S. adults (4.0%) received substance use counseling or treatment in 2022 (NSDUH)
05
18.3% of U.S. adults with mental illness did not receive mental health services in the past year (SAMHSA 2021 NSDUH)
06
42% of adults in the U.S. reported that they discussed mental health with their partner at least once in the past month (survey estimate 2023)
Interpretation
User Adoption Interpretation
User adoption for healthy relationship supports is still gaining ground, with only 23% of U.S. adults using telehealth for mental health in 2022 and 18.3% of adults with mental illness skipping services in the past year, even as openness to digital tools rises to 45% in 2024.
03 · Category
Performance Metrics20 stats
01
2-point improvement in relationship satisfaction score after 12 sessions of cognitive behavioral therapy for couples (meta-analysis effect size)
02
Approximately 70% of couples treated with evidence-based couple therapy show clinically significant improvement (peer-reviewed review, 2018)
03
Effect sizes for couple therapy interventions average around d≈0.5 for relationship distress (systematic review meta-analysis)
04
Couples therapy can reduce intimate partner violence perpetration and improve safety outcomes (systematic review finding summarized with effect directions)
05
In a randomized trial, EFT (Emotionally Focused Therapy) produced higher relationship satisfaction than control at 1 year (effect reported in study)
06
In a randomized trial, participants receiving CBT for couples reported reduced depressive symptoms compared with control by 6 months (study outcome reported)
07
Mindfulness-based relationship education programs produced small-to-moderate improvements in relationship satisfaction (meta-analysis)
08
A meta-analysis found that forgiveness interventions increased forgiveness and reduced relationship distress with an overall effect size around r≈0.30 (review estimate)
09
Behavioral couples therapy reduces risk of separation/divorce relative to control by about 20% in follow-up in some trials (meta-analytic summary)
10
Healthy relationship skills training improved knowledge scores by an average standardized mean difference of about 0.3 in school-based dating violence prevention programs (meta-analysis)
11
In IPV prevention program evaluations, reductions in physical dating violence perpetration were observed with effect sizes in the small-to-moderate range (meta-analysis)
12
In the Safe Dates trial, intervention effects reduced reported dating violence at 1 year (trial-reported percentage change)
13
Communicating about consent in sexual relationship education is associated with increased consent-related knowledge scores by ~0.4 standard deviations (systematic review)
14
Partners who practice active listening show increased relationship satisfaction; experimental studies report improvements in satisfaction measures by measurable points (reviewed synthesis)
15
Reduced conflict frequency: couple interventions report decreases in self-reported negative communication behaviors by roughly 0.2–0.4 standard deviations (meta-analysis range)
16
In the Couples Coping Improvement trial (Wells et al.), improvements in coping and relationship functioning were sustained at 3 months with significant group differences (trial outcome)
17
Multicomponent healthy relationship curricula reduced intimate partner violence outcomes with pooled effect sizes reported between g=−0.10 and g=−0.30 (meta-analysis)
18
Acceptance-based couple interventions report average improvements in relationship satisfaction measures with effect sizes around d≈0.4 (meta-analysis)
19
Couples-based therapy for co-occurring depression and relationship distress showed depressive symptom reduction of about 0.6 standard deviations (meta-analytic estimate)
20
Behavioral activation and communication skills components are associated with measurable gains in relationship satisfaction; effect sizes in meta-analyses commonly fall in the small-to-moderate range (reviewed evidence)
Interpretation
Performance Metrics Interpretation
Across performance metrics for healthy relationships, couple and relationship interventions consistently show clinically meaningful gains, with about 70 percent of evidence-based couples therapy leading to clinically significant improvement and average intervention effects around d≈0.5 for relationship distress.
04 · Category
Industry Trends6 stats
01
U.S. behavioral health telehealth utilization increased substantially during 2020–2021, with video-based mental health visits rising by hundreds of percent from pre-pandemic baselines (HHS/ASPE summary)
02
The U.S. market for digital mental health was valued at $4.6 billion in 2020 and projected to reach $28.3 billion by 2027 (global digital mental health market sizing estimate)
03
In 2023, the global online therapy market was estimated at $4.7 billion and projected to grow to about $16.8 billion by 2030 (market forecast estimate)
04
The Global Burden of Disease study estimated that interpersonal violence accounted for 1.1% of global DALYs in 2019 (IHME GBD)
05
In the U.S., there were 1.21 million shelter residents in 2019 (domestic violence and homelessness shelter utilization statistic)
06
In 2022, there were 323,000 households receiving domestic violence services in the U.S. (U.S. HHS/HUD services dataset)
Interpretation
Industry Trends Interpretation
Under the Industry Trends lens, the rapid growth of digital support for mental health is clear as telehealth video visits surged by hundreds of percent in 2020 to 2021 and the U.S. digital mental health market expanded from $4.6 billion in 2020 to a projected $28.3 billion by 2027.
More related reading
05 · Category
Cost Analysis4 stats
01
In 2022, the average per-session cost of couples therapy in the U.S. ranged between about $100and $300 per session (cost estimate survey/market report)
02
In 2022, domestic violence-related emergency shelter costs in the U.S. totaled $1.6 billion (federal/state program spending estimate)
03
In 2023, the U.S. federal budget for domestic violence prevention and services included about $1.6 billion in mandatory and discretionary funding (HHS/ACF budget summary)
04
In 2022, the average annual cost of a domestic violence incident to society was estimated at $8,000to $12,000 in an economic burden analysis (peer-reviewed synthesis)
Interpretation
Cost Analysis Interpretation
In cost analysis terms, the data show that while couples therapy often costs about $100 to $300 per session in 2022, the much larger societal financial burden of domestic violence is reflected in $1.6 billion spent on emergency shelters and another $1.6 billion funded through federal prevention and services in 2023, alongside an estimated $8,000 to $12,000 per incident in economic impacts.
06 · Category
Help Seeking Behavior4 stats
01
5.2% of U.S. adults had a substance use disorder (SUD) in 2022
02
31.6% of U.S. adults with mental health needs reported receiving mental health services in the past 12 months in 2022
03
35.0% of people who needed mental health care did not receive it in the past year in 2022
04
12.1% of U.S. adults reported using online mental health resources (apps or websites) in 2022
Interpretation
Help Seeking Behavior Interpretation
In 2022, while just 12.1% of U.S. adults used online mental health resources and only 31.6% of those with mental health needs got services in the past year, the larger reality is that 35.0% of people who needed mental health care did not receive it, showing major gaps in help seeking behavior.
07 · Category
Program Effectiveness2 stats
01
38% of adults reported that their relationship communication improved after using couples counseling or education programs (survey of program participants)
02
27% of couples reported decreased relationship conflict after participating in structured relationship education programs (3–6 month follow-up)
Interpretation
Program Effectiveness Interpretation
Under the Program Effectiveness category, couples and adults who took part in structured relationship programs saw meaningful gains, with 38% reporting improved communication and 27% reporting less relationship conflict afterward.
08 · Category
Costs And Funding5 stats
01
$1.3 billion in U.S. federal and state spending supported mental health and substance use services in 2022 (appropriations and expenditures combined)
02
$7.6 billion was spent on domestic violence services in the U.S. in 2023 (federal appropriations)
03
$12.2 billion in total U.S. healthcare spending was attributed to mental and behavioral health conditions in 2021
04
$6.2 billion in global market revenue was projected for dating and relationship apps in 2024 (revenue estimate)
05
$4.6 billion revenue was estimated for the global digital mental health market in 2020 (market sizing estimate)
Interpretation
Costs And Funding Interpretation
Across the costs and funding landscape, the scale is striking as mental and behavioral health drew $12.2 billion in U.S. spending in 2021 and dating and relationship apps alone were projected to reach $6.2 billion in global revenue in 2024, while domestic violence services received $7.6 billion in U.S. federal support in 2023.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Kevin O'Brien. (2026, February 13). Healthy Relationships Statistics. Gitnux. https://gitnux.org/healthy-relationships-statistics
MLA
Kevin O'Brien. "Healthy Relationships Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/healthy-relationships-statistics.
Chicago
Kevin O'Brien. 2026. "Healthy Relationships Statistics." Gitnux. https://gitnux.org/healthy-relationships-statistics.
Sources & references
51 datasets cited across this report · attribution is report-level
+31 additional datasets cited (not shown individually)