Waverly Hills Sanatorium - Louisville, KY
America’s OCD Care Crisis: Why Most People Aren’t Getting the Right Treatment
Despite being highly treatable, OCD is one of the most commonly misunderstood mental health conditions and many people never receive the kind of care that actually works. Too often, individuals are misdiagnosed, given well-meaning but ineffective therapy, or left trying to manage symptoms on their own. At River City OCD Clinic, we see the impact of this gap every day, and it’s a big part of why specialized, evidence-based treatment for OCD matters.
In 2025, the International OCD Foundation (IOCDF) analyzed over 10 million U.S. health records to better understand how OCD is diagnosed and treated in real-world settings. You can read their original release here.
The findings point to a major gap between what works and what people actually receive.
The Problem: OCD Is Often Missed
OCD affects up to 3% of the population.
But in the IOCDF's release, their study found that only 0.5–0.7% of patients had a documented diagnosis.
That means a large number of people with OCD are:
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Misdiagnosed due to a lack of awareness of OCD themes and subtypes
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Overlooked entirely
For many, this leads to years of unnecessary suffering.
Effective Treatment Is Rare
Even when OCD is correctly diagnosed, most people still don’t receive the right treatment.
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Only about 2% received Exposure and Response Prevention (ERP)
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The majority were never referred for evidence-based care
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Between 81% and 98% were not receiving effective treatment
Instead, many receive:
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Symptom management without addressing the OCD cycle
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No treatment at all
What Actually Works for OCD
The gold-standard treatment for OCD is Exposure and Response Prevention (ERP).
ERP helps people face fears and reduce compulsions, changing how the brain responds to anxiety and uncertainty.
Acceptance and Commitment Therapy (ACT) is often used alongside ERP to help people:
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Stay engaged in exposure
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Respond differently to intrusive thoughts
Why the Gap Exists
Misdiagnosis and careless treatment planning exist due to:
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Limited training in OCD for many clinicians
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Misunderstanding of symptoms and OCD themes & subtypes
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Underuse of ERP and ACT, despite strong evidence
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Low public awareness, leading to delayed help-seeking
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Lazy assessment practices leading to misdiagnosis with symptoms explained away as generalized anxiety disorder, social anxiety disorder, and even psychosis
What needs to change?
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Earlier identification through screening and proper assessment practices
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Greater awareness of how lived experience actually looks in real life
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Increased access to specialized care
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Responsible disclosure of specialty areas on popular therapist directories
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Therapists who aren't trained to provide ERP and ACT should seek professional consultation or refer individuals to an OCD specialist
We (Clinicians) Can and Must Do Better
OCD is not rare. More importantly, OCD is a treatable condition.
The problem isn’t a lack of solutions. It’s that those solutions aren’t reaching most people.
Services That Target OCD Using Evidence-Based Approaches are Accessible in Kentucky, Indiana, and Many Locations Today
At River City OCD Clinic, our clinicians specialize in ACT-enhanced ERP for all OCD subtypes and presentations, as well as anxiety and perfectionism. We offer individual therapy, group therapy, intensive outpatient treatment (IOP), and telehealth services throughout Kentucky and across participating PSYPACT states through Dr. Street Russell.