Progress in addressing mental health is notoriously slow and mostly incremental. Breakthrough treatments tend to be rare, and trained professionals too few to meet the demand for services, which is increasing. But 2024 was a pivotal year—thanks to the culmination of decades of research and post-pandemic attention to mental-health issues.

In March, the U.S. Food and Drug Administration (FDA) approved Rejoyn, the first digital therapeutic to treat major depressive disorder. The app opens the door to a new class of therapies that could dramatically increase access to treatment. Six months later, the FDA approved the first new drug for schizophrenia in 30 years, Cobenfy. It targets a different brain chemical system than previous treatments. And psychedelics notched a first when the FDA reviewed a request to approve MDMA for the treatment of posttraumatic stress disorder. Though this bid ultimately failed—the agency wanted to see more research—the FDA remains open to this group of drugs as a promising new way to treat certain mental-health conditions.

These advances come at a time when the need for mental-health services has never been more urgent. About a fifth of teens in the U.S. report symptoms of anxiety or depression, according to the most recently analyzed federal survey data from 2021–22, but 20% say they can’t afford therapy to address their symptoms. The national lifeline for mental-health crises, 988, fielded around 5.3 million calls, texts or chats this year. And the U.S. surgeon general raised the alarm about two major mental-health issues: first calling for warning labels about the dangers of social media for young people, and then highlighting the extraordinary stress and anxiety parents experience in raising families today.

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Clearly, more help is needed. “The problem is that there are so few trained personnel,” says Dr. Ashish Jha, dean of the school of public health at Brown University and former White House COVID-19 response coordinator. But innovations like those introduced this year can help to ease the load on mental-health professionals. The schizophrenia drug Cobenfy solves a number of problems that plague current treatments, which aren’t very effective and come with such severe side effects that up to half of patients stop taking them—it targets a circuit in the brain that patients seem to tolerate better, and has been shown to reduce symptoms like hallucinations, paranoia, and delusions. That could help more people to get the treatment they need.

Rejoyn, which was approved as a supplement to existing treatments, lets people take their mental health into their own hands through a smartphone app. It prompts users to remember emotions depicted on people’s faces, which requires them to use both the emotional and cognitive processing centers of their brain. In studies, people who used Rejoyn for six weeks showed more balanced activity in these brain centers and had fewer depression symptoms. That “rewiring” may make people more responsive to traditional treatments like cognitive behavior therapy or antidepressants.

These advances may have reached patients in 2024, but they didn’t develop in a year, or even a few. Each took decades of basic scientific research, trial and error, and careful testing in people. That’s true not just of mental-health innovations, but with advances in all areas of medicine: 2024 also saw the first genetically edited pig-to-human kidney transplant, the first patients receiving CRISPR-edited gene therapy for sickle cell disease, the rise of the most powerful medications yet to treat obesity, and unprecedented remissions for the most challenging cancers. “I’ve been following life sciences for decades, and I have never seen acceleration at this level, and spread across so many different areas,” says Dr. Eric Topol, founder and director of the Scripps Research Translational Institute.

As the incoming Trump Administration threatens to reduce federal research budgets while shrinking health agencies in the name of efficiency, health experts fear such momentum could slow, ultimately narrowing the treatment pipeline for a number of diseases. The impact might not be felt immediately, but could result in fewer innovations in coming years. “The National Institutes of Health (NIH) is an agency that invests in long-term scientific progress,” says Jha. “What I worry about is that if we are going to make a bunch of cuts to NIH, we might not see any negative health effects this year, but it will hurt the next generation more than it will hurt people today. Today’s miracles come from fundamental investments that happened a decade or two decades ago.”

Philanthropists and the private sector could step in to help fill the funding gap. But that may mean the investments won’t be as broad and diverse as government-driven funding, and might prioritize specific conditions, widening the already significant gaps in access to essential health services such as those for mental health.

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Even more disturbing than the immediate risk of potential cuts to research budgets is a deeper mistrust in science and scientists that is part of a larger “culture of hostility to expertise,” says Dr. Ezekiel Emanuel, vice provost for global initiatives at the University of Pennsylvania, who has served in both the Office of Management and Budget and the NIH. “Someone being an expert in an area used to get them a lot of authority, reverence, and respect. Now it’s more than likely to get them real hostility, name-calling, and denigrating attacks. It’s very distressing, because this is occurring simultaneously as we revel in all the fruits that science is producing.”

Restoring trust in science is necessary to keep up the medical progress that improves lives this and every year. Such advances are critical in mental health, as rates of illness and demand for treatment continues to rise. Innovative developments, including novel treatments and new ways of thinking about how to incorporate digital technologies, are important first steps to increasing access and addressing unmet needs.

Those investments must continue, since in the U.S., “even though we have a lot of health problems, things are starting to get better,” Jha says. “And the reason things are getting better is because of long-term investments into the NIH and the work of public health and biomedical scientists.”