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Youth Ranking 2021



 

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States with rankings 1-10 have lower prevalence of mental illness and higher rates of access to care for youth. States with rankings 39-51 indicate that youth have higher prevalence of mental illness and lower rates of access to care.

The 7 measures that make up the Youth Ranking include:

  1.  Youth with At Least One Major Depressive Episode (MDE) in the Past Year
  2.  Youth with Substance Use Disorder in the Past Year
  3.  Youth with Severe MDE
  4.  Youth with MDE who Did Not Receive Mental Health Services
  5.  Youth with Severe MDE who Received Some Consistent Treatment
  6.  Children with Private Insurance that Did Not Cover Mental or Emotional Problems
  7.  Students Identified with Emotional Disturbance for an Individualized Education Program.


Statistical Data for Youth Data 2021


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

Youth with At Least One Major Depressive Episode (MDE) in the Past Year 2021



 

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13.84% of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year.

Childhood depression is more likely to persist into adulthood if gone untreated.

The number of youth experiencing MDE increased by 206,000 from last year's dataset.

The state prevalence of youth with MDE ranges from 10.53% in the District of Columbia to 17.57% in Oregon.



Statistical Data for Youth with At Least One Major Depressive Episode (MDE) in the Past Year 2021

Rank Sort descending State Percentage Number
01 District of Columbia 10.53 3,000
02 New York 11.40 157,000
03 Pennsylvania 11.88 109,000
04 New Jersey 11.95 82,000
05 Mississippi 12.15 29,000
06 Tennessee 12.27 63,000
07 Georgia 12.52 108,000
08 South Dakota 12.53 9,000
09 Louisiana 12.84 46,000
10 Hawaii 12.93 12,000
11 Maryland 13.02 59,000
12 Delaware 13.05 9,000
13 Alabama 13.13 49,000
14 Florida 13.17 189,000
15 Texas 13.20 325,000
16 Rhode Island 13.40 10,000
17 South Carolina 13.56 51,000
18 Kentucky 13.61 46,000
19 California 13.71 415,000
20 Ohio 13.73 123,000
21 North Dakota 13.75 7,000
22 Massachusetts 13.86 67,000
23 Colorado 13.99 60,000
24 Minnesota 14.04 61,000
25 Nebraska 14.20 22,000
26 Connecticut 14.24 39,000
27 Virginia 14.28 90,000
28 Montana 14.40 11,000
29 Vermont 14.65 6,000
30 West Virginia 14.66 18,000
31 Arkansas 14.74 35,000
32 Missouri 14.78 69,000
33 Illinois 14.86 148,000
34 Wyoming 14.91 7,000
35 Kansas 14.95 35,000
36 North Carolina 15.05 119,000
37 New Hampshire 15.08 14,000
38 Iowa 15.09 37,000
39 Nevada 15.11 35,000
40 Alaska 15.21 9,000
41 Wisconsin 15.31 68,000
42 Michigan 15.36 117,000
43 Maine 15.45 14,000
44 Washington 15.66 85,000
45 Indiana 15.71 84,000
46 Arizona 15.93 89,000
47 Oklahoma 16.48 52,000
48 Utah 16.64 51,000
49 Idaho 16.70 26,000
50 New Mexico 17.43 29,000
51 Oregon 17.57 52,000
52 National 13.84 3,449,000

Youth with Severe Major Depressive Episode 2021



 

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9.7% of youth (or over 2.3 million youth) cope with severe major depression. Depression in youth often co-occurs with other disorders like substance use, anxiety and disorderly behavior.

The number of youths experiencing Severe MDE increased by 126,000 from last year's dataset.

The state prevalence of youth with Severe MDE ranges from 6.3% in Mississippi to 13.5% in Maine.



Statistical Data for Youth with Severe Major Depressive Episode 2021

Rank Sort descending State Percentage Number
01 Mississippi 6.3 15000
02 Alabama 6.4 23000
03 District of Columbia 6.8 2000
04 Pennsylvania 7.1 64000
05 New York 7.8 105000
06 South Dakota 8 5000
07 New Jersey 8.1 54000
08 Hawaii 8.5 8000
09 North Dakota 8.5 4000
10 Massachusetts 8.5 40000
11 California 8.7 256000
12 Colorado 8.7 36000
13 New Hampshire 8.7 8000
14 Connecticut 9 24000
15 Nebraska 9 14000
16 Ohio 9.1 79000
17 Texas 9.2 219000
18 Louisiana 9.2 33000
19 Tennessee 9.2 46000
20 Florida 9.3 128000
21 Georgia 9.3 78000
22 Delaware 9.3 6000
23 Rhode Island 9.5 7000
24 Kentucky 9.6 31000
25 Iowa 9.8 23000
26 Maryland 9.8 42000
27 Minnesota 9.8 41000
28 South Carolina 9.8 36000
29 Kansas 9.9 23000
30 Virginia 10.2 62000
31 Washington 10.3 53000
32 Montana 10.4 8000
33 Missouri 10.4 47000
34 Alaska 10.7 6000
35 Arkansas 10.7 25000
36 Vermont 10.7 4000
37 Illinois 11 104000
38 Michigan 11.3 84000
39 Nevada 11.8 26000
40 Utah 11.9 36000
41 Wyoming 12 5000
42 West Virginia 12.5 15000
43 Arizona 12.5 66000
44 North Carolina 12.6 98000
45 Idaho 12.7 19000
46 Indiana 12.7 66000
47 Oklahoma 12.7 39000
48 Oregon 13.1 37000
49 New Mexico 13.1 21000
50 Wisconsin 13.4 58000
51 Maine 13.5 12000
52 National 9.7 2343000

Youth with Substance Use Disorder in the Past Year



 

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3.83% of youth in the U.S. reported having a substance use disorder in the past year.  

1.69% had an alcohol use disorder in the past year, while 2.85% had an illicit drug use disorder.

The state prevalence of youth with substance use disorder ranges from 3.16% in Utah to 5.61% in Vermont.



Statistical Data for Youth with Substance Use Disorder in the Past Year 2021

Rank Sort descending State Percentage Number
01 Utah 3.16 10,000
02 Georgia 3.20 28,000
03 Texas 3.24 80,000
04 Maryland 3.26 15,000
05 Mississippi 3.30 8,000
06 Indiana 3.37 18,000
07 New York 3.41 47,000
08 New Jersey 3.42 23,000
09 Pennsylvania 3.42 31,000
10 Virginia 3.56 22,000
11 North Carolina 3.57 28,000
12 Louisiana 3.58 13,000
13 Kansas 3.63 9,000
14 Alabama 3.63 14,000
15 Michigan 3.64 28,000
16 Missouri 3.69 17,000
17 Nebraska 3.69 6,000
18 Kentucky 3.77 13,000
19 Minnesota 3.86 17,000
20 Connecticut 3.86 11,000
21 Tennessee 3.91 20,000
22 Massachusetts 3.92 19,000
23 South Carolina 3.95 15,000
24 Idaho 3.97 6,000
25 Ohio 3.97 36,000
26 Hawaii 4.04 4,000
27 California 4.04 122,000
28 Illinois 4.04 40,000
29 Rhode Island 4.05 3,000
30 Wisconsin 4.07 18,000
31 Arizona 4.08 23,000
32 West Virginia 4.08 5,000
33 Arkansas 4.11 10,000
34 Delaware 4.15 3,000
35 Oklahoma 4.19 13,000
36 Iowa 4.21 10,000
37 Florida 4.34 62,000
38 Alaska 4.37 3,000
39 North Dakota 4.38 2,000
40 New Hampshire 4.41 4,000
41 Maine 4.59 4,000
42 Wyoming 4.63 2,000
43 Oregon 4.65 14,000
44 South Dakota 4.78 3,000
45 New Mexico 4.80 8,000
46 Washington 5.01 27,000
47 Nevada 5.09 12,000
48 Colorado 5.12 22,000
49 Montana 5.18 4,000
50 District of Columbia 5.42 2,000
51 Vermont 5.61 2,000
52 National 3.83 954,000

Youth with MDE who Did Not Receive Mental Health Services 2021



 

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59.6% of youth with major depression do not receive any mental health treatment.

Youth experiencing MDE continue to go untreated. Even among the states with greatest access for youth, over 1 in 3 youth are still not receiving the mental health services they need.

The state prevalence of untreated youth with depression ranges from 38.6% in Maine to 71.0% in Nevada.



Statistical Data for Youth with MDE who Did Not Receive Mental Health Services

Rank Sort descending State Percentage Number
01 Maine 38.6 6000
02 District of Columbia 38.8 1000
03 Vermont 40.7 2000
04 Maryland 41.3 23000
05 Utah 45.2 22000
06 Washington 47 38000
07 Wisconsin 47.2 33000
08 Delaware 47.9 4000
09 Kentucky 49.3 19000
10 South Dakota 49.7 3000
11 Ohio 52.2 59000
12 Virginia 53 51000
13 Indiana 53 48000
14 Iowa 53 20000
15 North Dakota 53.4 3000
16 Rhode Island 53.4 5000
17 Oregon 53.9 30000
18 Kansas 54.7 19000
19 Louisiana 54.9 24000
20 Minnesota 55.4 32000
21 Nebraska 55.4 12000
22 Montana 55.6 5000
23 Michigan 55.7 66000
24 New Jersey 55.7 40000
25 Hawaii 56.2 5000
26 Wyoming 56.6 4000
27 New Hampshire 56.9 9000
28 Pennsylvania 57.5 56000
29 Alaska 57.8 5000
30 Missouri 58.8 40000
31 New York 59.1 85000
32 Connecticut 59.1 24000
33 West Virginia 59.3 11000
34 Arizona 59.6 52000
35 North Carolina 60.2 77000
36 Colorado 60.9 29000
37 Oklahoma 61.1 35000
38 Idaho 61.2 15000
39 Massachusetts 61.2 41000
40 Tennessee 61.5 35000
41 Illinois 62.1 90000
42 New Mexico 62.9 20000
43 Arkansas 63.9 23000
44 Florida 64.7 116000
45 California 66 259000
46 Mississippi 66.3 18000
47 Texas 67.1 209000
48 South Carolina 68 36000
49 Alabama 69.7 31000
50 Georgia 70.4 73000
51 Nevada 71 23000
52 National 59.60% 1988000

Youth with Severe MDE who Received Some Consistent Treatment 2021



 

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High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes.


Nationally, only 27.3% of youth with severe depression receive some consistent treatment (7-25+ visits in a year). 

Late recognition in primary care settings and limited coverage of mental health services often prevent youth from receiving timely and effective treatment.

The state prevalence of youth with severe depression who received some outpatient treatment ranges from 50.0% in Maine to 11.2% in Nevada.



Statistical Data for Youth with Severe MDE who Received Some Consistent Treatment 2021

Rank Sort descending State Percentage Number
01 Maine 50 5000
02 Maryland 49.2 21000
03 Vermont 45.4 2000
04 Delaware 41.5 2000
05 Rhode Island 41.2 3000
06 Wisconsin 40.4 23000
07 Oregon 37.9 14000
08 Massachusetts 37.7 15000
09 District of Columbia 37.3 1000
10 Pennsylvania 37.1 23000
11 Wyoming 36.3 2000
12 Ohio 36 28000
13 Nebraska 35.9 5000
14 Idaho 35.8 6000
15 New Hampshire 34.9 3000
16 Kentucky 34.2 10000
17 Minnesota 33.7 13000
18 North Dakota 33 1000
19 New Jersey 32.5 16000
20 Louisiana 32 9000
21 Kansas 31.1 7000
22 Arkansas 30 7000
23 Alaska 29.9 2000
24 Michigan 29.8 24000
25 Montana 29.3 2000
26 South Dakota 29.2 1000
27 Iowa 28.8 7000
28 South Carolina 28.3 9000
29 Hawaii 28.3 2000
30 West Virginia 27.8 4000
31 Tennessee 27.3 12000
32 Washington 26.7 13000
33 Indiana 26.1 16000
34 Virginia 26.1 16000
35 Alabama 25.9 6000
36 Texas 25 54000
37 Illinois 25 26000
38 Arizona 24.7 15000
39 California 24.6 59000
40 Utah 24.5 8000
41 Oklahoma 23.5 8000
42 New Mexico 22.6 5000
43 New York 21.9 22000
44 North Carolina 21.9 21000
45 Connecticut 21.6 5000
46 Colorado 21.5 8000
47 Florida 19.7 24000
48 Georgia 19.2 15000
49 Missouri 19 9000
50 Mississippi 14.9 2000
51 Nevada 11.2 3000
52 National 27.3 614000

Children with Private Insurance that Did Not Cover Mental or Emotional Problems 2021



 

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The Mental Health Parity and Addiction Equity law (MHPAE) was enacted in 2008, and promised the equal coverage of mental health and substance use services. The rate of children with private insurance that does not cover mental or emotional problems decreased 0.3% from last year's dataset. However, there are still 901,000 youth without coverage for their behavioral health. 

In 2019, a Milliman research report found large disparities between behavioral health and medical/surgical services, including that patients saw out-of-network behavioral health providers at much higher rates than physical health providers. It also found that these disparities were worse for children. In 2017, a behavioral health visit for a child was over 10 times more likely to be out-of-network than a primary care office visit. This was over two times the disparity shown for adults. 

To improve the worsening mental health of children and adolescents in the U.S., insurance companies must not only achieve parity in coverage of services, but also in network adequacy, so people are able to access those services when they need them. 

The state prevalence of children lacking mental health coverage ranges from 0.6% in Vermont to 14.8% in South Carolina.



Statistical Data for Children with Private Insurance that Did Not Cover Mental or Emotional Problems 2021

Rank Sort descending State Percentage Number
01 Vermont 0.6 0
02 Massachusetts 1.2 4000
03 New Hampshire 2.5 1000
04 Connecticut 3.3 5000
05 Maine 3.4 2000
06 New Jersey 4 14000
07 District of Columbia 4.6 1000
08 Washington 5.2 16000
09 Rhode Island 5.3 2000
10 Montana 5.4 2000
11 South Dakota 5.4 2000
12 Michigan 5.5 23000
13 Wisconsin 5.5 16000
14 Ohio 5.9 26000
15 Missouri 5.9 14000
16 Alabama 5.9 7000
17 Pennsylvania 6.1 29000
18 Georgia 6.5 23000
19 Virginia 6.6 21000
20 Oregon 6.7 10000
21 Delaware 6.9 3000
22 Indiana 7.1 22000
23 Illinois 7.2 34000
24 Maryland 7.2 18000
25 West Virginia 7.2 4000
26 California 7.5 100000
27 Minnesota 7.5 20000
28 Mississippi 7.5 6000
29 Iowa 7.5 10000
30 Louisiana 7.6 10000
31 New Mexico 7.8 4000
32 Utah 7.8 16000
33 Oklahoma 7.9 11000
34 Kansas 7.9 9000
35 New York 8.3 49000
36 Colorado 8.3 17000
37 Hawaii 9.2 3000
38 Florida 9.4 52000
39 North Carolina 10 33000
40 Alaska 10.3 2000
41 Kentucky 11 17000
42 Texas 11.5 108000
43 Wyoming 12 3000
44 Arizona 12.1 32000
45 Nevada 12.6 13000
46 Nebraska 12.6 10000
47 Idaho 12.7 10000
48 North Dakota 13.5 5000
49 Tennessee 13.5 27000
50 Arkansas 14.4 13000
51 South Carolina 14.8 23000
52 National 7.8 901000

Students Identified with Emotional Disturbance for an Individualized Education Program 2021



 

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High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes


Only .757% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).

For purposes of an IEP, the term ìEmotional Disturbanceî is used to define youth with a mental illness that is affecting their ability to succeed in school.

Early identification for IEPs is critical. IEPs provide the services, accommodations and support students with ED need to receive a quality education. Inadequate education leads to poor outcomes such as low academic achievement, social isolation, unemployment, and involvement in the juvenile system. Further, the federal eligibility criteria to identify students as having an emotional disturbance for an IEP have indicated extremely poor reliability among school psychologists,2 and therefore must be revised to adequately identify students in need of more supports.

The rate for this measure is shown as a rate per 1,000 students.

The calculation was made this way for ease of reading.Unfortunately, doing so hides the fact that the percentages are significantly lower. If states were doing a better job of identifying whether youth had emotional difficulties that could be better supported through an IEP ñ the rates would be closer to 8% instead of .8 percent.

The state rate of students identified as having an emotional disturbance for an IEP ranges from 30.41 per 1,000 students in Vermont to 2.09 per 1,000 students in Alabama.



Statistical Data for Students Identified with Emotional Disturbance for an Individualized Education Program

Rank Sort descending State Percentage Number
01 Vermont 30.41 2233
02 Minnesota 20.69 16510
03 Massachusetts 19.51 16935
04 Wisconsin 16.18 *
05 Pennsylvania 15.76 25166
06 Maine 14.35 2328
07 Indiana 13.41 12838
08 Iowa 13.31 5896
09 New Hampshire 12.77 2095
10 Rhode Island 12.38 1615
11 District of Columbia 12.32 827
12 Connecticut 11.94 5691
13 North Dakota 11.85 1183
14 Illinois 10.19 18237
15 Nebraska 10.06 2846
16 Ohio 9.97 15377
17 South Dakota 9.89 1213
18 Oregon 9.81 5286
19 Delaware 9.25 1152
20 New York 9.15 22553
21 Missouri 8.66 7072
22 Michigan 8.45 11458
23 Virginia 8.38 9782
24 Maryland 7.64 6107
25 Mississippi 7.62 3326
26 Arizona 7.61 7742
27 Kentucky 7.45 4524
28 Oklahoma 6.89 4142
29 Colorado 6.88 5596
30 Wyoming 6.72 579
31 Texas 6.60 31519
32 Montana 6.50 881
33 Georgia 6.45 10286
34 Alaska 6.26 745
35 New Mexico 6.16 1853
36 New Jersey 5.98 7485
37 Hawaii 5.74 947
38 Florida 5.68 14604
39 Kansas 5.53 2436
40 Washington 5.25 5324
41 Idaho 4.95 1372
42 West Virginia 4.80 1133
43 Nevada 4.43 1959
44 California 4.42 25118
45 Tennessee 3.76 3381
46 North Carolina 3.72 5275
47 Utah 3.17 1918
48 South Carolina 3.04 2112
49 Louisiana 2.70 1715
50 Arkansas 2.42 1070
51 Alabama 2.09 1406
52 National 7.57 344473