Wisconsin, Pennsylvania, and Massachusetts scored best and Kansas, Oregon and Arizona worst in an annual report that ranks the mental health of each state based on rates of mental illness and care in each state.

This year’s State of Mental Health in America Report, produced by Mental Health America, a nonprofit research and advocacy organization, painted a picture of a country experiencing high rates of mental illness, limited access to services and significant barriers to care. 

These trends come after almost three years of a pandemic that has claimed the lives of more than 1 million people and caused more than 9 million to experience the death of a close relative. At the same time, fatal drug overdoses have continued to spike and are expected to top 100,000 this year for the second year in a row.

“We do think that there’s going to be a long tail to the recovery from the mental health impact of the pandemic,” said Schroeder Stribiling, president and CEO of Mental Health America. “We know that rates of deaths of despair, substance use, opioid overdose, alcohol-related deaths, suicides have all increased during this time.”

Although researchers caution that pandemic-related changes in data collection make year-to-year comparisons difficult, the broad implications of a worsening mental health and substance use picture are clear.

An overall ranking of 1-13 indicates lower prevalence of mental illness and higher rates of access to care. An overall ranking of 39-51 indicates higher prevalence of mental illness and lower rates of access to care. The combined scores of all 15 measures make up the overall ranking. The overall ranking includes both adult and youth measures, as well as prevalence and access to care measures.

Among its key findings, the study found that:

  • Over 50 million adults in America — or about 20% — experienced a mental illness.
  • 15% of adults had a substance use disorder in the past year. Of those adults, 93.5% did not receive treatment.
  • 55% of adults with mental illness receive no treatment.
  • 11% of adults with a mental illness are uninsured
  • More than 2.7 million youth are experiencing severe major depression.
  • 60% of youth with major depression don’t receive treatment.

Significant racial disparities were also evident in the rates of people receiving treatment. For example, the 60% of young people with depression who weren’t getting care grew to 68% among Black youth and 78% among Asian youth. 

Mental Health America, which was founded in 1909, has been releasing the yearly report since 2015. The findings were based largely on data from a large survey, the National Survey of Drug Use and Health, collected by SAMHSA, the Substance Abuse and Mental Health Services Administration. 

Report authors Maddy Reinert, Theresa Nguyen, and Danielle Fritze used the data to examine the prevalence of mental health and substance use disorders in each state and the District of Columbia, and to assess people’s access to insurance and services, along with the barriers to treatment present in each place. 

Stribling said she hoped that the study will “better equip states to see where there are high levels of unmet needs, and to open the opportunity to learn from the experience and practices of others.” 

The report looked at 15 metrics to produce an overall ranking as well as separate ratings on the state of youth and adult mental health in each state. It found major differences among states in how well they addressed services for youth versus adults.

For example, Kentucky, which was ranked number 11 in overall mental health, was number one when just looking at adults. Hawaii, which was ranked 18th overall, is number two for adults, according to the report.

Kansas, which was ranked last overall, is ranked near the bottom of almost every list in the report.

The full report is available for download here, and state rankings on different services can be viewed  here.

Type of work:

Josh McGhee

Staff reporter Josh McGhee covers the intersection of criminal justice and mental health with an emphasis on public records and data reporting. He previously reported for Injustice Watch, the Chicago Reporter,...