Access to Care Ranking 2023

 
empty

The Access Ranking indicates how much access to mental health care exists within a state. The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and workforce availability. A high Access Ranking (1-13) indicates that a state provides relatively more access to insurance and mental health treatment.

The 9 measures that make up the Access Ranking include:

  1.  Adults with AMI who Did Not Receive Treatment
  2.  Adults with AMI Reporting Unmet Need
  3. Adults with AMI who are Uninsured
  4.  Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs
  5.  Youth with MDE Who Did Not Receive Mental Health Services
  6.  Youth with Severe MDE who Received Some Consistent Treatment
  7.  Youth with Private Insurance that Did Not Cover Mental or Emotional Problems
  8.  Students (K+) Identified with Emotional Disturbance for an Individualized Education Program
  9.  Mental Health Workforce Availability
Rank State
01 Vermont
02 Massachusetts
03 Illinois
04 Montana
05 District of Columbia
06 Pennsylvania
07 New Hampshire
08 Connecticut
09 Wisconsin
10 Rhode Island
11 Maine
12 South Dakota
13 Washington
14 Minnesota
15 Delaware
16 New Mexico
17 Iowa
18 North Dakota
19 New York
20 Michigan
21 Ohio
22 Utah
23 New Jersey
24 Kentucky
25 Maryland
26 Colorado
27 Oklahoma
28 Alaska
29 Nebraska
30 Oregon
31 California
32 Hawaii
33 West Virginia
34 Virginia
35 Idaho
36 Missouri
37 Louisiana
38 Nevada
39 North Carolina
40 Tennessee
41 Wyoming
42 Mississippi
43 Indiana
44 South Carolina
45 Arkansas
46 Florida
47 Arizona
48 Kansas
49 Georgia
50 Alabama
51 Texas

Adults with AMI Who Are Uninsured 2023

 
empty

10.8% (over 5.5 million) of adults with a mental illness are uninsured.

The state prevalence of uninsured adults with mental illness ranges from 4.1% in Rhode Island to 24.7% in Wyoming.

Rank State Percentage Number
01 Rhode Island 4.10% 8,000
02 Massachusetts 4.60% 54,000
03 Kentucky 4.70% 34,000
04 District of Columbia 5.60% 8,000
05 New York 5.60% 158,000
06 Vermont 5.80% 7,000
07 Wisconsin 5.80% 55,000
08 Connecticut 6.00% 27,000
09 Illinois 6.30% 122,000
10 Virginia 6.50% 87,000
11 Michigan 6.70% 117,000
12 Alaska 6.80% 8,000
13 Maryland 6.90% 53,000
14 Pennsylvania 6.90% 134,000
15 Hawaii 7.10% 14,000
16 Washington 7.20% 111,000
17 California 7.50% 456,000
18 Montana 7.90% 15,000
19 Utah 7.90% 57,000
20 Delaware 8.30% 13,000
21 North Dakota 8.30% 9,000
22 Tennessee 9.30% 95,000
23 Iowa 9.40% 44,000
24 Nevada 10.00% 51,000
25 West Virginia 10.00% 40,000
26 Ohio 10.20% 226,000
27 Oregon 10.20% 94,000
28 Colorado 10.40% 107,000
29 New Mexico 10.40% 36,000
30 Louisiana 11.00% 80,000
31 Idaho 12.10% 40,000
32 Arkansas 12.20% 62,000
33 Minnesota 12.20% 124,000
34 Oklahoma 12.30% 105,000
35 New Jersey 12.70% 155,000
36 Mississippi 13.20% 64,000
37 South Carolina 13.20% 122,000
38 New Hampshire 13.40% 38,000
39 Indiana 13.50% 142,000
40 Florida 13.60% 393,000
41 South Dakota 13.90% 17,000
42 Maine 14.10% 34,000
43 Arizona 14.90% 202,000
44 Nebraska 15.50% 51,000
45 North Carolina 15.80% 236,000
46 Missouri 16.70% 155,000
47 Georgia 17.40% 218,000
48 Kansas 17.50% 107,000
49 Alabama 17.90% 138,000
50 Texas 21.40% 798,000
51 Wyoming 24.70% 26,000
52 National 10.80% 5,544,000

Adults with AMI Who Did Not Receive Treatment 2023

 
empty

Over half (54.7%) of adults with a mental illness receive no treatment. 

Over 28 million individuals experiencing a mental illness are going untreated.

Of adults with a mental illness who did not receive treatment in the past year, 26.7% indicated that they had experienced serious psychological distress in the past month.

The state prevalence of untreated adults with mental illness ranges from 40.6% in Montana to 69.1% in Hawaii.

Rank State Percentage Number
01 Montana 40.60% 78,000
02 Nebraska 42.40% 138,000
03 Massachusetts 42.80% 500,000
04 Vermont 43.10% 49,000
05 Arkansas 45.50% 230,000
06 South Dakota 45.80% 55,000
07 New Mexico 46.40% 157,000
08 Tennessee 46.40% 470,000
09 Wisconsin 46.80% 443,000
10 Iowa 47.20% 222,000
11 Virginia 47.40% 630,000
12 Delaware 48.40% 76,000
13 North Dakota 48.40% 52,000
14 New Hampshire 49.20% 141,000
15 Michigan 49.40% 870,000
16 Rhode Island 49.60% 99,000
17 Minnesota 49.80% 505,000
18 Missouri 50.00% 461,000
19 Washington 50.00% 765,000
20 Utah 50.40% 360,000
21 South Carolina 50.50% 467,000
22 West Virginia 50.80% 201,000
23 Illinois 50.90% 980,000
24 North Carolina 51.10% 762,000
25 Indiana 51.20% 530,000
26 Idaho 51.60% 171,000
27 Kentucky 51.80% 378,000
28 Pennsylvania 51.80% 1,006,000
29 Kansas 52.30% 320,000
30 Louisiana 52.90% 385,000
31 Maine 53.50% 127,000
32 Oklahoma 53.50% 457,000
33 Wyoming 54.00% 56,000
34 Oregon 54.10% 494,000
35 Alaska 54.90% 61,000
36 Maryland 55.00% 422,000
37 Colorado 55.50% 570,000
38 District of Columbia 55.50% 75,000
39 Ohio 55.60% 1,232,000
40 Connecticut 55.80% 248,000
41 Mississippi 56.10% 273,000
42 New Jersey 56.20% 677,000
43 Georgia 57.80% 722,000
44 New York 58.00% 1,637,000
45 Florida 58.40% 1,679,000
46 Nevada 61.40% 309,000
47 Texas 62.30% 2,306,000
48 Alabama 62.40% 478,000
49 California 62.60% 3,757,000
50 Arizona 63.50% 854,000
51 Hawaii 69.10% 130,000
52 National 54.70% 28,066,000

Adults with AMI Reporting Unmet Need 2023

 
empty

Almost a third (28.2%) of all adults with a mental illness reported that they were not able to receive the treatment they needed.

Individuals reporting unmet need are those seeking treatment and facing barriers to getting the help they need.

Cost of care remains a significant barrier for many individuals in the U.S. Most adults with AMI who reported unmet need for treatment indicated that they did not receive care because they could not afford it (42%).

The state prevalence of adults with AMI reporting unmet treatment needs ranges from 18.4% in West Virginia to 38.8% in Indiana.

Rank State Percentage Number
01 West Virginia 18.40% 73,000
02 Hawaii 20.20% 38,000
03 Wisconsin 20.90% 198,000
04 South Carolina 21.30% 197,000
05 Washington 21.70% 331,000
06 New Jersey 22.90% 277,000
07 Kentucky 23.00% 168,000
08 Nebraska 23.00% 76,000
09 New York 24.00% 681,000
10 Pennsylvania 24.70% 477,000
11 Mississippi 24.80% 121,000
12 Montana 24.90% 48,000
13 Iowa 25.40% 120,000
14 Illinois 25.90% 501,000
15 Michigan 25.90% 455,000
16 Oklahoma 26.00% 222,000
17 North Carolina 26.30% 393,000
18 Connecticut 26.60% 118,000
19 Vermont 26.60% 30,000
20 Minnesota 26.70% 270,000
21 New Hampshire 26.70% 77,000
22 Wyoming 27.20% 28,000
23 Maine 27.40% 65,000
24 South Dakota 27.40% 33,000
25 Rhode Island 27.70% 56,000
26 California 27.80% 1,672,000
27 North Dakota 28.20% 30,000
28 Ohio 28.30% 628,000
29 Arkansas 28.70% 146,000
30 Florida 29.10% 838,000
31 Georgia 29.10% 363,000
32 Louisiana 29.10% 211,000
33 Missouri 29.60% 274,000
34 Texas 29.60% 1,101,000
35 Alaska 29.80% 33,000
36 Delaware 30.90% 49,000
37 Massachusetts 31.10% 364,000
38 Tennessee 31.40% 323,000
39 Virginia 31.50% 417,000
40 District of Columbia 32.20% 44,000
41 Idaho 32.20% 107,000
42 Maryland 32.50% 249,000
43 Oregon 32.60% 297,000
44 New Mexico 32.90% 112,000
45 Utah 34.10% 244,000
46 Colorado 34.20% 353,000
47 Alabama 35.40% 271,000
48 Kansas 35.80% 219,000
49 Arizona 36.00% 484,000
50 Nevada 37.60% 189,000
51 Indiana 38.80% 406,000
52 National 28.20% 14,476,000

Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs 2023

 
empty

22.87% of adults who reported experiencing 14 or more mentally unhealthy days each month were not able to see a doctor due to costs.

Mentally unhealthy days are derived from the question, “Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?” Having 14 or more mentally unhealthy days each month is defined as experiencing frequent mental distress.

The prevalence of adults with 14+ mentally unhealthy days a month who could not see a doctor due to cost ranges from 11.57% in Hawaii to 34.35% in Georgia.

Rank State Percentage Number
01 Montana 40.60% 78,000
02 Nebraska 42.40% 138,000
03 Massachusetts 42.80% 500,000
04 Vermont 43.10% 49,000
05 Arkansas 45.50% 230,000
06 South Dakota 45.80% 55,000
07 New Mexico 46.40% 157,000
08 Tennessee 46.40% 470,000
09 Wisconsin 46.80% 443,000
10 Iowa 47.20% 222,000
11 Virginia 47.40% 630,000
12 Delaware 48.40% 76,000
13 North Dakota 48.40% 52,000
14 New Hampshire 49.20% 141,000
15 Michigan 49.40% 870,000
16 Rhode Island 49.60% 99,000
17 Minnesota 49.80% 505,000
18 Missouri 50.00% 461,000
19 Washington 50.00% 765,000
20 Utah 50.40% 360,000
21 South Carolina 50.50% 467,000
22 West Virginia 50.80% 201,000
23 Illinois 50.90% 980,000
24 North Carolina 51.10% 762,000
25 Indiana 51.20% 530,000
26 Idaho 51.60% 171,000
27 Kentucky 51.80% 378,000
28 Pennsylvania 51.80% 1,006,000
29 Kansas 52.30% 320,000
30 Louisiana 52.90% 385,000
31 Maine 53.50% 127,000
32 Oklahoma 53.50% 457,000
33 Wyoming 54.00% 56,000
34 Oregon 54.10% 494,000
35 Alaska 54.90% 61,000
36 Maryland 55.00% 422,000
37 Colorado 55.50% 570,000
38 District of Columbia 55.50% 75,000
39 Ohio 55.60% 1,232,000
40 Connecticut 55.80% 248,000
41 Mississippi 56.10% 273,000
42 New Jersey 56.20% 677,000
43 Georgia 57.80% 722,000
44 New York 58.00% 1,637,000
45 Florida 58.40% 1,679,000
46 Nevada 61.40% 309,000
47 Texas 62.30% 2,306,000
48 Alabama 62.40% 478,000
49 California 62.60% 3,757,000
50 Arizona 63.50% 854,000
51 Hawaii 69.10% 130,000
52 National 54.70% 28,066,000

Youth with MDE Who Did Not Receive Mental Health Services 2023

 
empty

59.8% of youth with major depression did not receive any mental health treatment.

In Kentucky, Hawaii, and Texas, three-quarters of youth with major depression did not receive mental health treatment. In South Carolina, the lowest ranking state, nearly 8 in 10 youth with depression do not receive care.

The state prevalence of untreated youth with depression ranges from 32.6% in the District of Columbia to 77.1% in South Carolina.

Rank State Percentage Number
01 District of Columbia 32.60% 1,000
02 Colorado 34.40% 20,000
03 New Hampshire 35.90% 6,000
04 Montana 37.10% 5,000
05 New Mexico 38.30% 11,000
06 Illinois 39.90% 65,000
07 Connecticut 42.90% 16,000
08 South Dakota 43.40% 7,000
09 Utah 44.40% 26,000
10 North Dakota 44.90% 5,000
11 Idaho 47.80% 18,000
12 Delaware 47.90% 4,000
13 Maine 49.70% 8,000
14 Wyoming 50.40% 3,000
15 Nevada 50.70% 22,000
16 Vermont 51.00% 3,000
17 Louisiana 52.80% 37,000
18 New York 53.10% 105,000
19 Wisconsin 53.40% 23,000
20 Alabama 53.50% 31,000
21 Ohio 53.50% 86,000
22 New Jersey 54.10% 36,000
23 Mississippi 54.50% 20,000
24 Pennsylvania 54.60% 59,000
25 Arkansas 55.10% 22,000
26 Alaska 55.60% 6,000
27 Indiana 55.60% 39,000
28 Arizona 55.90% 51,000
29 Iowa 56.50% 25,000
30 Kansas 56.50% 23,000
31 Minnesota 56.80% 54,000
32 Oklahoma 57.40% 23,000
33 Washington 57.70% 61,000
34 Maryland 59.20% 47,000
35 Virginia 60.20% 90,000
36 Michigan 60.30% 71,000
37 North Carolina 61.70% 64,000
38 Florida 61.80% 146,000
39 Rhode Island 62.10% 7,000
40 Nebraska 63.70% 19,000
41 Massachusetts 63.90% 47,000
42 Oregon 64.30% 43,000
43 Missouri 65.30% 49,000
44 Georgia 66.60% 76,000
45 West Virginia 68.80% 16,000
46 California 69.50% 287,000
47 Tennessee 71.10% 72,000
48 Kentucky 74.70% 29,000
49 Hawaii 74.90% 12,000
50 Texas 74.90% 306,000
51 South Carolina 77.10% 29,000
52 National 59.80% 2,331,000

Youth with Severe MDE Who Received Some Consistent Treatment 2023

 
empty

Nationally, only 28% of youth with severe depression receive some consistent treatment (7-25+ visits in a year). 

14.7% of youth with severe MDE received 1-6 visits in the previous year. Most (57.3%) youth with severe depression do not receive any care.

The state prevalence of youth with severe depression who received some outpatient treatment ranges from 58.1% in South Dakota to 6.5% in Kansas.

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

Rank State Percentage Number
01 South Dakota 58.10% 8,000
02 Colorado 57.40% 27,000
03 North Dakota 51.20% 4,000
04 New Hampshire 46.80% 5,000
05 Massachusetts 46.30% 17,000
06 Delaware 45.30% 3,000
07 Illinois 44.70% 56,000
08 Oklahoma 44.70% 14,000
09 Alabama 44.60% 21,000
10 Maine 43.20% 6,000
11 New Mexico 43.20% 8,000
12 New Jersey 42.50% 18,000
13 Montana 39.70% 3,000
14 Vermont 39.60% 2,000
15 Ohio 38.60% 45,000
16 Pennsylvania 38.10% 25,000
17 Virginia 34.90% 33,000
18 Maryland 34.50% 18,000
19 Idaho 34.10% 9,000
20 District of Columbia 34.00% 1,000
21 New York 34.00% 45,000
22 Wyoming 33.30% 1,000
23 Nevada 33.00% 10,000
24 Utah 32.50% 14,000
25 Minnesota 30.70% 19,000
26 Washington 30.70% 21,000
27 Wisconsin 30.60% 10,000
28 Iowa 30.20% 10,000
29 Florida 26.50% 45,000
30 California 25.40% 68,000
31 Mississippi 24.30% 5,000
32 Arizona 24.20% 17,000
33 South Carolina 24.20% *
34 Michigan 23.60% 19,000
35 Connecticut 22.30% 6,000
36 Indiana 22.10% 12,000
37 Missouri 21.20% 13,000
38 Alaska 19.70% 2,000
39 North Carolina 19.70% 14,000
40 Arkansas 19.50% 4,000
41 West Virginia 18.00% 3,000
42 Georgia 17.40% 14,000
43 Kentucky 16.40% 5,000
44 Nebraska 16.00% 3,000
45 Rhode Island 13.90% 1,000
46 Tennessee 13.70% 7,000
47 Oregon 13.00% 7,000
48 Texas 12.70% 33,000
49 Louisiana 12.10% 4,000
50 Hawaii 11.40% 1,000
51 Kansas 6.50% 2,000
52 National 28.20% 737,000

Youth with Private Insurance that Did Not Cover Mental or Emotional Problems 2023

 
empty

Nationally, 1 in 10 youth who are covered under private insurance do not have coverage for mental or emotional difficulties – totaling over 1.2 million youth.

In Arkansas (ranked 51), nearly one-quarter of youth with private insurance do not have coverage for mental health care.

The state prevalence of youth lacking mental health coverage ranges from 1.4% in Rhode Island to 23.2% in Arkansas.

Students (K+) Identified with Emotional Disturbance for An Individualized Education Program 2023

 
empty

Only .718% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).

For purposes of an IEP, the term “Emotional Disturbance” is used to define youth with a mental or behavioral health condition that is affecting their educational performance.

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.

The state rate of students identified as having an emotional disturbance for an IEP ranges from 30.60 per 1,000 students in Vermont to 1.82 per 1,000 students in Alabama.

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

 

Rank State Percentage Number
01 Vermont 30.60 2,317
02 Minnesota 19.80 16,848
03 Massachusetts 19.14 17,230
04 Pennsylvania 15.37 26,081
05 Wisconsin 14.78 11,575
06 Maine 14.57 2,444
07 Iowa 13.31 *
08 Indiana 12.03 12,236
09 New Hampshire 11.67 1,937
10 North Dakota 11.50 1,290
11 Connecticut 11.41 5,636
12 Rhode Island 11.29 1,546
13 Illinois 9.76 17,797
14 Oregon 9.67 5,425
15 Nebraska 9.39 2,881
16 District of Columbia 9.34 728
17 Ohio 9.14 14,768
18 South Dakota 8.67 1,182
19 Delaware 8.56 1,164
20 Missouri 8.25 7,056
21 New York 8.19 20,857
22 Virginia 7.73 9,463
23 Michigan 7.63 10,702
24 Texas 7.25 37,375
25 Kentucky 7.03 4,489
26 Mississippi 6.88 3,005
27 Arizona 6.87 7,547
28 Maryland 6.54 5,615
29 Colorado 6.29 5,390
30 Wyoming 6.26 577
31 Montana 5.92 857
32 New Mexico 5.90 1,821
33 Oklahoma 5.90 3,877
34 Georgia 5.77 9,731
35 Alaska 5.74 725
36 Hawaii 5.19 907
37 Washington 5.16 5,510
38 Kansas 5.14 2,377
39 New Jersey 5.13 6,760
40 Florida 4.70 12,875
41 Idaho 4.61 1,404
42 Nevada 4.39 2,077
43 California 4.06 24,370
44 West Virginia 3.97 956
45 Tennessee 3.41 3,272
46 North Carolina 3.33 4,976
47 South Carolina 2.81 2,098
48 Louisiana 2.74 *
49 Utah 2.66 1,776
50 Arkansas 2.28 1,080
51 Alabama 1.82 1,303
52 National 7.18 345,350

Mental Health Workforce Availability 2023

 
empty

In the U.S., there are 350 individuals for every one mental health provider. The term “mental health provider” includes psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care.

As of June 2022, over 152 million people lived in a mental health workforce shortage area, and only 28% of the mental health need in shortage areas was being met by mental health providers.

The state rate of mental health workforce ranges from 140:1 in Massachusetts to 850:1 in Alabama.

Rank State Number
01 Massachusetts 140:1
02 Alaska 160:1
03 Oregon 170:1
04 District of Columbia 180:1
05 Maine 190:1
06 Vermont 200:1
07 Rhode Island 220:1
08 Connecticut 230:1
09 Washington 230:1
10 California 240:1
11 New Mexico 240:1
12 Oklahoma 240:1
13 Colorado 250:1
14 Wyoming 270:1
15 Utah 280:1
16 New Hampshire 290:1
17 Montana 300:1
18 Louisiana 310:1
19 New York 310:1
20 Maryland 330:1
21 Michigan 330:1
22 Delaware 340:1
23 Minnesota 340:1
24 Nebraska 340:1
25 Ohio 350:1
26 Hawaii 360:1
27 North Carolina 360:1
28 Illinois 370:1
29 New Jersey 380:1
30 Kentucky 390:1
31 Arkansas 400:1
32 Nevada 420:1
33 Pennsylvania 420:1
34 Idaho 440:1
35 Wisconsin 440:1
36 Missouri 460:1
37 Kansas 470:1
38 North Dakota 470:1
39 Virginia 480:1
40 South Dakota 500:1
41 South Carolina 520:1
42 Mississippi 540:1
43 Florida 550:1
44 Indiana 560:1
45 Iowa 570:1
46 Tennessee 590:1
47 Georgia 640:1
48 Arizona 660:1
49 West Virginia 670:1
50 Texas 760:1
51 Alabama 850:1
52 National 350:1