Adult Ranking 2020

States that are ranked 1-13 have lower prevalence of mental illness and higher rates of access to care for adults. States that are ranked 39-51 indicate that adults have higher prevalence of mental illness and lower rates of access to care.

The 7 measures that make up the Adult Ranking include:

Adults with Any Mental Illness (AMI)
Adults with Substance Use Disorder in the Past Year
Adults with Serious Thoughts of Suicide
Adults with AMI who are Uninsured
Adults with AMI who Did Not Receive Treatment
Adults with AMI Reporting Unmet Need
Adults with Disability Who Could Not See a Doctor Due to Costs

Rank Sort descending	State
01	Hawaii
02	New York
03	New Jersey
04	Minnesota
05	Pennsylvania
06	Michigan
07	Maryland
08	New Mexico
09	Massachusetts
10	Vermont
11	Illinois
12	Connecticut
13	Delaware
14	Ohio
15	Texas
16	Kentucky
17	Arizona
18	Tennessee
19	Iowa
20	South Dakota
21	California
22	Nebraska
23	North Dakota
24	Wisconsin
25	Florida
26	Rhode Island
27	West Virginia
28	New Hampshire
29	Virginia
30	Arkansas
31	Maine
32	South Carolina
33	Louisiana
34	Montana
35	North Carolina
36	District of Columbia
37	Washington
38	Kansas
39	Indiana
40	Alabama
41	Oklahoma
42	Nevada
43	Georgia
44	Missouri
45	Mississippi
46	Wyoming
47	Idaho
48	Colorado
49	Oregon
50	Alaska
51	Utah

Adult Prevalence of Mental Illness - Adults with Any Mental Illness (AMI) 2020

18.57% of adults are experiencing a mental health illness, equivalent to 45 million Americans.
4.38% are experiencing a severe mental health illness.
The state prevalence of adult mental illness ranges from 16.19% in New Jersey to 25.03% in Idaho.

Rank Sort descending	State	Percentage	Number
01	New Jersey	16.14	1,112,000
02	Texas	16.21	3,347,000
03	Maryland	16.96	781,000
04	Virginia	17.38	1,115,000
05	Florida	17.39	2,889,000
06	South Dakota	17.49	112,000
07	Hawaii	17.58	187,000
08	Illinois	18.06	1,754,000
09	Nebraska	18.08	257,000
10	Georgia	18.09	1,405,000
11	Pennsylvania	18.23	1,814,000
12	New York	18.25	2,802,000
13	Tennessee	18.26	937,000
14	South Carolina	18.31	706,000
15	California	18.54	5,566,000
16	North Carolina	18.77	1,469,000
17	Connecticut	19.03	531,000
18	Michigan	19.07	1,469,000
19	New Mexico	19.10	300,000
20	North Dakota	19.13	108,000
21	Arizona	19.24	1,030,000
22	Wisconsin	19.26	859,000
23	Minnesota	19.32	819,000
24	Mississippi	19.49	431,000
25	Kansas	19.59	420,000
26	Iowa	19.89	473,000
27	Montana	20.00	163,000
28	Delaware	20.03	149,000
29	Arkansas	20.27	457,000
30	Wyoming	20.34	88,000
31	Oklahoma	20.43	592,000
32	Alaska	20.50	108,000
33	New Hampshire	20.56	221,000
34	Louisiana	20.63	715,000
35	Vermont	20.65	104,000
36	Nevada	20.67	474,000
37	Maine	20.82	223,000
38	Massachusetts	21.22	1,155,000
39	Rhode Island	21.32	178,000
40	Alabama	21.39	794,000
41	Ohio	21.40	1,906,000
42	Missouri	21.44	993,000
43	Colorado	21.50	924,000
44	Kentucky	22.14	746,000
45	District of Columbia	22.21	125,000
46	Washington	22.23	1,269,000
47	Oregon	22.45	731,000
48	Indiana	22.51	1,129,000
49	West Virginia	23.80	337,000
50	Idaho	24.46	311,000
51	Utah	25.25	550,000
52	National	19.00	47,132,000

Adult with Substance Use Disorder in the Past Year 2020

7.68% of adults in America reported having a substance use disorder in the past year;
2.72% an illicit drug use disorder in the past year;
5.82% an alcohol use disorder in the past year.
The state prevalence of adults with substance use disorder in the past year ranges from 6.32% in Georgia to 11.55% in the District of Columbia.

Substance Use Disorder is defined as meeting criteria for illicit drug or alcohol dependence or abuse. Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than told; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs.

Rank Sort descending	State	Percentage	Number
01	Texas	6.34	1,308,000
02	Utah	6.42	140,000
03	Florida	6.68	1,109,000
04	West Virginia	6.76	96,000
05	Georgia	6.77	526,000
06	Mississippi	6.77	150,000
07	Maryland	6.89	317,000
08	North Carolina	6.95	544,000
09	Tennessee	6.95	357,000
10	New Jersey	7.01	483,000
11	Hawaii	7.13	76,000
12	Minnesota	7.24	307,000
13	Wyoming	7.25	31,000
14	Kansas	7.27	156,000
15	Pennsylvania	7.30	727,000
16	Virginia	7.32	470,000
17	Arizona	7.36	394,000
18	Indiana	7.39	371,000
19	Kentucky	7.46	251,000
20	Alabama	7.46	277,000
21	Michigan	7.47	576,000
22	New Mexico	7.53	118,000
23	New York	7.57	1,162,000
24	Missouri	7.57	351,000
25	South Carolina	7.60	293,000
26	Ohio	7.64	680,000
27	Idaho	7.76	99,000
28	Nebraska	8.01	114,000
29	Arkansas	8.02	181,000
30	California	8.12	2,437,000
31	Illinois	8.16	793,000
32	Washington	8.53	487,000
33	Oklahoma	8.54	248,000
34	Wisconsin	8.68	387,000
35	Louisiana	8.69	301,000
36	Delaware	8.76	65,000
37	North Dakota	8.79	50,000
38	Rhode Island	8.80	74,000
39	Connecticut	8.82	246,000
40	Nevada	9.00	206,000
41	New Hampshire	9.09	98,000
42	Iowa	9.13	217,000
43	South Dakota	9.17	59,000
44	Maine	9.27	99,000
45	Massachusetts	9.34	508,000
46	Montana	9.41	76,000
47	Alaska	9.76	51,000
48	Oregon	9.94	323,000
49	Vermont	10.51	53,000
50	Colorado	11.90	511,000
51	District of Columbia	13.01	73,000
52	National	7.67	19,026,000

Adults with Serious Thoughts of Suicide 2020

The percentage of adults reporting serious thoughts of suicide is 4.19%.
The estimated number of adults with serious suicidal thoughts is over 10.3 million—an increase of nearly 450,000 people from last year’s data set.
The state prevalence of adults with serious thoughts of suicide range from New Jersey at 3.41% to Utah at 5.99%.

Rank Sort descending	State	Percentage	Number
01	New Jersey	3.41%	235000
02	Florida	3.49%	569000
03	New York	3.68%	568000
04	Texas	3.72%	754000
05	Illinois	3.87%	376000
06	Alabama	3.89%	144000
07	Michigan	3.99%	306000
08	Maine	3.99%	43000
09	Maryland	4.00%	184000
10	Mississippi	4.01%	88000
11	New Mexico	4.01%	63000
12	Arizona	4.02%	211000
13	Missouri	4.04%	186000
14	California	4.04%	1205000
15	Nebraska	4.05%	57000
16	Connecticut	4.05%	113000
17	Hawaii	4.08%	43000
18	Oklahoma	4.10%	118000
19	District of Columbia	4.11%	23000
20	South Carolina	4.11%	156000
21	Delaware	4.16%	31000
22	Virginia	4.20%	268000
23	Louisiana	4.25%	147000
24	Pennsylvania	4.28%	426000
25	Georgia	4.38%	336000
26	Wyoming	4.39%	19000
27	South Dakota	4.40%	28000
28	Tennessee	4.50%	228000
29	Minnesota	4.52%	190000
30	Ohio	4.56%	404000
31	North Dakota	4.57%	26000
32	North Carolina	4.57%	352000
33	Massachusetts	4.57%	247000
34	Arkansas	4.59%	103000
35	Wisconsin	4.60%	204000
36	Nevada	4.62%	104000
37	Iowa	4.69%	111000
38	Kentucky	4.71%	158000
39	West Virginia	4.75%	68000
40	Rhode Island	4.78%	40000
41	Kansas	4.87%	104000
42	New Hampshire	4.89%	52000
43	Montana	4.91%	39000
44	Indiana	5.04%	251000
45	Washington	5.06%	283000
46	Oregon	5.18%	166000
47	Vermont	5.31%	27000
48	Alaska	5.34%	28000
49	Colorado	5.41%	229000
50	Idaho	5.60%	70000
51	Utah	5.99%	128000
52	National	4.19%	10308000

Adults with AMI who are Uninsured 2020

10.3% (over 4.7 million) of adults with a mental illness remain uninsured.
Under the Affordable Care Act (ACA), the U.S. continues to see a decline in Americans who are uninsured. There was a 1.9 percent reduction from last year’s dataset.

Thirty-nine states saw a reduction in Adults with AMI who are uninsured. The largest reductions were seen in Louisiana (5.3%), New York (4.7%), Iowa (4.6%) and Arkansas (4.2%).

Each of the bottom 17 states, with the exception of Louisiana, are states that have not expanded Medicaid. Louisiana, however, has had the largest reductions in the rate of uninsured adults with AMI since the state expanded Medicaid in 2016, from 20 percent of adults with AMI to 14.7%.

The rankings for this indicator used data from the 2016-2017 NSDUH. Some states, such as Arkansas, that had a reduction in uninsured adults with AMI passed Medicaid work requirements in 2018, which may lead to a large change in coverage in future reports.

The state prevalence of uninsured adults with mental illness ranges from 2.4% in Massachusetts to 22.9% in Wyoming.

Rank Sort descending	State	Percentage	Number
01	District of Columbia	2.5	3000
02	Vermont	3.9	4000
03	Massachusetts	4.2	51000
04	Connecticut	4.6	25000
05	Kentucky	4.8	37000
06	New York	5.1	139000
07	Rhode Island	5.8	11000
08	Pennsylvania	6	108000
09	Michigan	6.4	93000
10	New Mexico	6.4	19000
11	Hawaii	6.4	12000
12	Delaware	6.8	10000
13	Maryland	7	55000
14	Ohio	7.1	138000
15	Minnesota	7.3	58000
16	Wisconsin	7.4	62000
17	New Hampshire	7.5	17000
18	California	7.8	434000
19	South Dakota	8.2	9000
20	West Virginia	8.3	31000
21	Iowa	8.4	39000
22	New Jersey	8.8	94000
23	North Dakota	8.8	9000
24	Illinois	8.9	151000
25	Colorado	9	84000
26	Oregon	9	67000
27	Arizona	9.6	97000
28	Louisiana	9.7	72000
29	Nebraska	10.3	25000
30	Montana	10.3	17000
31	Nevada	10.5	51000
32	Washington	10.6	140000
33	Arkansas	10.9	51000
34	Indiana	11.4	134000
35	Alaska	11.6	12000
36	Utah	11.7	67000
37	Kansas	12.4	52000
38	South Carolina	12.5	85000
39	Maine	12.7	29000
40	Virginia	13.5	147000
41	Idaho	13.7	46000
42	North Carolina	13.8	204000
43	Oklahoma	15.9	92000
44	Missouri	16.2	169000
45	Florida	17.4	503000
46	Georgia	18.5	255000
47	Alabama	18.8	154000
48	Tennessee	19	171000
49	Texas	20.1	664000
50	Mississippi	22.2	95000
51	Wyoming	23	21000
52	National	10.8	511,400

Adults with AMI who Did Not Receive Treatment 2020

57.2% of adults with a mental illness received no treatment.
Over 26 million individuals experiencing a mental health illness are going untreated.
The state prevalence of untreated adults with mental illness ranges from 40.7% in Vermont to 64.8% in California.

Rank Sort descending	State	Percentage	Number
01	Vermont	42.8	45000
02	Arkansas	47.5	221000
03	Rhode Island	49	89000
04	Wisconsin	49.2	412000
05	Massachusetts	49.5	597000
06	Delaware	49.7	75000
07	Iowa	49.8	231000
08	Maine	49.9	114000
09	Ohio	50.7	978000
10	Kentucky	50.9	392000
11	Colorado	50.9	475000
12	Kansas	51.1	213000
13	Utah	51.2	294000
14	South Carolina	51.4	349000
15	Tennessee	51.7	463000
16	New Hampshire	51.9	116000
17	West Virginia	52.2	193000
18	District of Columbia	52.2	68000
19	Minnesota	52.6	416000
20	Arizona	52.7	535000
21	Pennsylvania	53	953000
22	Nebraska	53	128000
23	Washington	53.5	704000
24	Idaho	53.5	177000
25	Michigan	53.8	779000
26	Connecticut	53.9	287000
27	Montana	54.2	89000
28	Virginia	54.5	589000
29	North Dakota	54.5	56000
30	South Dakota	54.8	57000
31	Missouri	55.3	576000
32	Illinois	55.8	946000
33	Indiana	55.9	653000
34	North Carolina	56.5	833000
35	New Mexico	56.6	167000
36	Alabama	56.7	463000
37	Mississippi	57.7	247000
38	Oklahoma	58.9	340000
39	Maryland	59.1	459000
40	Oregon	59.3	442000
41	Texas	59.6	1960000
42	New Jersey	60	644000
43	New York	60.3	1655000
44	Nevada	60.3	282000
45	Louisiana	62	459000
46	Florida	63	1816000
47	Wyoming	64.8	60000
48	Georgia	64.9	888000
49	California	65	3620000
50	Alaska	65.5	70000
51	Hawaii	65.8	124000
52	National	57	267,970

Adults with AMI Reporting Unmet Need 2020

Almost a quarter (22.3%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. This number has not declined since 2011.

Individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment:

No insurance or limited coverage of services
Shortfall in psychiatrists, and an overall undersized mental health workforce.
Lack of available treatment types (inpatient treatment, individual therapy, intensive community services).
Disconnect between primary care systems and behavioral health systems.
Insufficient finances to cover costs – including, copays, uncovered treatment types, or when providers do not take insurance.

The state prevalence of adults with AMI reporting unmet treatment needs ranges from 14.3% in Alabama to 31.2% in Utah.

Rank Sort descending	State	Percentage	Number
01	Alabama	14.3	106,000
02	Hawaii	14.7	25,000
03	Iowa	18.2	82,000
04	Texas	19.2	620,000
05	Wyoming	19.2	17,000
06	Minnesota	19.4	141,000
07	Maine	19.7	39,000
08	New York	20.1	536,000
09	Louisiana	20.2	133,000
10	Ohio	20.4	363,000
11	West Virginia	20.4	70,000
12	Vermont	20.7	21,000
13	North Dakota	21.2	21,000
14	Arizona	21.3	189,000
15	Idaho	21.7	72,000
16	South Dakota	21.7	24,000
17	Delaware	21.8	29,000
18	Illinois	21.8	331,000
19	North Carolina	21.8	302,000
20	California	21.9	1,196,000
21	Mississippi	21.9	92,000
22	Alaska	22	23,000
23	Florida	22	632,000
24	Michigan	22	307,000
25	Tennessee	22	208,000
26	Wisconsin	22	178,000
27	Colorado	22.2	186,000
28	Massachusetts	22.3	262,000
29	Oklahoma	22.4	129,000
30	Georgia	22.5	309,000
31	Maryland	22.6	180,000
32	Nebraska	22.6	54,000
33	Connecticut	22.9	113,000
34	Kentucky	22.9	178,000
35	New Jersey	22.9	254,000
36	Montana	23.3	36,000
37	New Mexico	23.8	65,000
38	Rhode Island	24.3	39,000
39	District of Columbia	24.5	30,000
40	Washington	24.5	327,000
41	Pennsylvania	24.7	435,000
42	South Carolina	24.8	173,000
43	Arkansas	25	119,000
44	Missouri	25	238,000
45	Indiana	25.2	272,000
46	Kansas	25.9	109,000
47	Virginia	28.3	337,000
48	Oregon	28.5	224,000
49	Nevada	28.6	121,000
50	New Hampshire	28.8	57,000
51	Utah	31.2	163,000

Adults with Disability Who Could Not See a Doctor Due to Costs 2020

29.4% of adults with a cognitive disability were not able to see a doctor due to costs.

According to the Centers for Disease Control (CDC), 11.4% of people in the United States had a cognitive disability, even when adjusted for age. 1 The percentage of people with cognitive disability ranged from 7.8 percent in some states to 19.1 percent.

A 2017 study found that compared to working-age adults without disabilities, those with disabilities are more likely to live below the federal poverty level and to use public insurance. Their average health costs were also 3-7 times higher than those without disabilities, and they were more likely to face access problems to care, including cost.

The prevalence of adults with disability who couldn’t see a MD due to cost ranges from 16.87% in Iowa to 41.03% in Texas.

Rank Sort descending	State	Percentage	Number
01	Iowa	16.87	37,908
02	Vermont	18.63	9,188
03	Massachusetts	20.44	110,799
04	Alaska	20.69	9,859
05	Rhode Island	20.7	20,592
06	Hawaii	20.86	19,358
07	Ohio	22.23	239,773
08	New York	22.35	315,572
09	California	22.47	647,176
10	Pennsylvania	22.97	254,064
11	Connecticut	23.06	51,647
12	New Hampshire	23.99	23,315
13	Minnesota	24.81	98,572
14	Montana	25.1	22,931
15	Delaware	25.4	24,687
16	Maryland	25.74	100,730
17	District of Columbia	25.88	14,059
18	Nebraska	26.66	33,510
19	Kentucky	26.77	145,055
20	Wisconsin	26.98	112,237
21	Washington	27.19	158,208
22	Michigan	27.29	280,450
23	West Virginia	27.54	74,517
24	North Dakota	27.67	12,131
25	Colorado	27.72	102,075
26	Oregon	28.37	103,596
27	Idaho	28.49	33,213
28	Indiana	28.78	167,315
29	Illinois	29.06	237,367
30	Maine	29.34	32,555
31	Arizona	29.84	170,006
32	Kansas	29.99	65,857
33	South Dakota	30.13	18,219
34	Nevada	30.76	77,939
35	South Carolina	30.79	147,202
36	Utah	31.19	70,771
37	Arkansas	31.42	107,117
38	New Mexico	31.51	61,938
39	Missouri	32.21	195,362
40	Tennessee	33.23	239,969
41	Alabama	33.24	191,499
42	North Carolina	33.36	290,888
43	Florida	33.37	684,912
44	Mississippi	33.97	113,045
45	Wyoming	34.35	15,974
46	Oklahoma	34.43	150,379
47	Virginia	34.48	213,282
48	New Jersey	35.07	245,583
49	Georgia	36.06	322,610
50	Louisiana	38.23	201,908
51	Texas	41.03	983,751

2020 Adult Data