America’s OCD Care Crisis: What the Latest Research Reveals

Obsessive-Compulsive Disorder (OCD) is a common and potentially debilitating mental health condition. Fortunately, highly effective treatments exist. Yet new national data shows that most people with OCD are still not receiving the care they need.

In December 2025, the International OCD Foundation (IOCDF) released a landmark “white paper” analyzing over 10 million U.S. health records to better understand how OCD is diagnosed and treated in real-world settings. Their findings highlight a troubling gap between what science tells us works and what most patients actually receive. 

Executive Summary: A Widespread Treatment Gap

The IOCDF report confirms what many people with OCD experience firsthand: OCD is severely underdiagnosed, and even when diagnosed, evidence-based treatment is rarely provided.

Although OCD affects up to 3% of the population, the study found that only about 0.5–0.7% of patients had a documented OCD diagnosis. This suggests that up to 75% of people with OCD may never be correctly identified by clinicians. 

Even more concerning, the vast majority of diagnosed patients did not receive the gold-standard therapy for OCD—Exposure and Response Prevention (ERP) or other evidence-based therapies such as Acceptance and Commitment Therapy (ACT), which is often used to enhance or support ERP by helping individuals relate differently to intrusive thoughts and anxiety.

Instead, many received no therapy at all or treatments that were not designed to target OCD specifically.

Key Findings: Most Patients Are Not Receiving Effective Treatment

The IOCDF identified two central problems in OCD care:

1. OCD Is Often Missed or Misdiagnosed

Out of more than 10 million patient records, fewer than 1% contained an OCD diagnosis—far below expected prevalence rates. This indicates that many individuals with OCD are being misdiagnosed or overlooked entirely. 

Delayed or incorrect diagnosis can keep people stuck for years in cycles of intrusive thoughts, compulsions, avoidance, and shame.

2. Evidence-Based Treatment Is Rare

Among those who were diagnosed:

• Only 2% had documented evidence of receiving ERP

• The majority were never referred for evidence-based OCD treatment at all

• Between 81% and 98% were not receiving effective, evidence-based treatment 

This is especially troubling given that ERP, often strengthened by ACT-based skills such as willingness, defusion, and values-based action, is widely recognized as the first-line treatment for OCD.

Without these targeted approaches, many individuals remain stuck managing symptoms rather than learning how to respond differently to them.

Recommendations: How OCD Care Can Improve

The IOCDF outlines several steps that could dramatically improve outcomes for people with OCD:

1. Routine Screening

Clinicians should use brief, validated OCD screening tools in both primary care and mental health settings. Earlier detection leads to earlier, more effective treatment. 

2. Better Training for Clinicians

Most mental health professionals receive limited training in diagnosing and treating OCD. The report calls for improved education in:

• Recognizing OCD

• Differentiating OCD from other anxiety or mood disorders

• Delivering ERP

• Using ACT-based approaches to support exposure work

The report calls for expanded training in both graduate programs and continuing education courses for licensed professionals. 

3. Adherence to Professional Guidelines

ERP remains underused despite decades of research supporting its effectiveness. The report emphasizes the need for stronger adherence to established OCD treatment standards.

This includes recognizing ACT as a complementary, evidence-based framework that helps individuals build flexibility in the presence of intrusive thoughts and fear.

4. Increased Public Awareness

Misunderstandings about OCD—such as viewing it as a personality quirk or cleanliness issue—contribute to delayed diagnosis and ineffective care. Education for the public, schools, and healthcare systems is essential. 

Why This Matters

The IOCDF findings point to a critical reality: Effective treatment for OCD exists, but access to it remains limited.

When people with OCD receive specialized care, many experience meaningful improvement and reclaim their lives. The gap between science and practice is not due to a lack of solutions, but a lack of implementation.

Closing this gap requires:

• Earlier identification

• Better clinician training

• Greater public understanding

• Improved access to OCD specialists

When people receive proper treatment—especially ERP or ERP supported by ACT principles—many experience meaningful relief and improved quality of life.

Our Commitment to Gold-Standard OCD Care

At Reclaim Wellness Group, we take these findings seriously. Our clinicians specialize in the assessment and treatment of OCD using gold-standard, evidence-based approaches, including:

• Exposure and Response Prevention (ERP)

• Acceptance and Commitment Therapy (ACT)

We believe OCD requires specialized care—not generic anxiety treatment—and that accurate diagnosis combined with targeted therapy is essential for recovery.

If you or a loved one may be struggling with OCD, working with clinicians trained specifically in OCD treatment can make a meaningful difference.

Source:

International OCD Foundation (2025). America’s OCD Care Crisis: National Findings on the Failure of Effective OCD Treatment to Reach Patients. Executive Summary, Key Findings, and Recommendations (pp. 4–6).