Subclinical mental health problems—distress and functional impairment that fall short of a clinical diagnosis—affect millions of US adults, yet are rarely addressed in research or policy. Using 2022–2023 data from the National Survey on Drug Use and Health, this brief finds that nearly 30 percent of Medicaid enrollees with unmet demand for mental health treatment have subclinical needs, compared with 23 percent of those with Medicare or other public coverage and 16 percent of privately insured adults. These Medicaid enrollees are disproportionately young—over half are younger than 26—but report high rates of poor health and substance use disorder. Among insured adults with subclinical mental health needs and unmet demand for treatment, barriers to care are widespread. Two-thirds of adults with subclinical needs said they preferred to manage problems on their own or feared being forced into care. Medicaid enrollees in this group were more likely than their privately insured counterparts to report cost barriers, difficulty finding a provider, and a lack of available appointments. To close access gaps, policies can expand affordable, person-centered care options that align with people’s preferences and symptom severity—especially for younger adults with Medicaid.