Adult Ranking 2023

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 a higher prevalence of mental illness and lower rates of access to care.

The seven 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 Did Not Receive Treatment
Adults with AMI Reporting Unmet Need
Adults with AMI Who are Uninsured
Adults Reporting 14+ Mentally Unhealthy Days a Month Who Could Not See a Doctor Due to Costs

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

Adult Prevalence of Any Mental Illness (AMI) 2023

The state prevalence of adult mental illness ranges from 17.49% in Florida to 29.68% in Utah.

According to SAMHSA, “Any Mental Illness (AMI) is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder as assessed by the Mental Health Surveillance Study (MHSS) Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition—Research Version—Axis I Disorders (MHSS-SCID), which is based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These estimates are based on indicators of AMI rather than direct measures of diagnostic status."

Rank Sort ascending	State	Percentage	Number
01	Florida	17.49	2,985,000
02	Georgia	17.55	1,397,000
03	Maryland	17.80	822,000
04	Hawaii	17.86	189,000
05	Texas	17.96	3,825,000
06	New Jersey	18.27	1,251,000
07	Connecticut	18.77	524,000
08	New York	18.83	2,855,000
09	Pennsylvania	19.68	1,963,000
10	North Carolina	19.80	1,592,000
11	Tennessee	20.46	1,073,000
12	California	20.49	6,169,000
13	Virginia	20.51	1,331,000
14	Delaware	20.52	156,000
15	Illinois	20.72	2,000,000
16	North Dakota	20.79	118,000
17	Iowa	21.00	503,000
18	Mississippi	21.06	465,000
19	New Mexico	21.16	337,000
20	Louisiana	21.18	733,000
21	Alabama	21.24	797,000
22	South Dakota	21.25	139,000
23	Missouri	21.32	996,000
24	Nevada	21.38	508,000
25	Massachusetts	21.39	1,172,000
26	Maine	21.61	234,000
27	South Carolina	21.69	862,000
28	Indiana	21.83	1,109,000
29	Wisconsin	21.83	982,000
30	Kentucky	21.91	742,000
31	Alaska	22.20	117,000
32	Michigan	22.33	1,729,000
33	Arkansas	22.61	514,000
34	District of Columbia	22.95	131,000
35	Colorado	23.16	1,028,000
36	Minnesota	23.23	997,000
37	Nebraska	23.41	335,000
38	Montana	23.43	195,000
39	Wyoming	23.63	103,000
40	Vermont	23.71	120,000
41	New Hampshire	23.74	260,000
42	Arizona	23.89	1,339,000
43	Rhode Island	24.12	202,000
44	Ohio	24.32	2,177,000
45	Idaho	24.92	333,000
46	Washington	25.51	1,500,000
47	Oklahoma	25.59	752,000
48	Kansas	26.02	560,000
49	West Virginia	26.05	366,000
50	Oregon	27.33	909,000
51	Utah	29.68	675,000
52	National	20.78	52,173,000

Adults with Substance Use Disorder 2023

15.35% of adults in America reported having a substance use disorder in the past year.

6.82% of adults in America had an illicit drug use disorder in the past year.

10.96% of adults in America had an alcohol use disorder in the past year.

Of those reporting having a substance use disorder in the past year, 93.5% did not receive any form of treatment.

The state prevalence of adults with substance use disorder ranges from 11.31% in Georgia to 21.21% in the District of Columbia.

According to SAMHSA, “Substance Use Disorder (SUD) data in 2020 are based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). SUD is defined as meeting the criteria for illicit drug or alcohol use disorder. SUD estimates are based on only 2020 data because prior years’ SUD data were based on DSM-IV criteria."

Rank Sort ascending	State	Percentage	Number
01	Georgia	11.31	906,000
02	Texas	11.93	2,564,000
03	Utah	12.64	291,000
04	Kentucky	12.98	441,000
05	North Carolina	13.48	1,092,000
06	Hawaii	13.77	145,000
07	Tennessee	13.94	734,000
08	South Carolina	14.08	564,000
09	Virginia	14.53	947,000
10	Indiana	14.61	745,000
11	Florida	14.81	2,541,000
12	Arkansas	14.85	339,000
13	New York	14.88	2,250,000
14	West Virginia	14.93	210,000
15	Alabama	14.94	563,000
16	Nevada	14.95	360,000
17	Idaho	15.02	204,000
18	Maryland	15.27	706,000
19	Ohio	15.36	1,377,000
20	New Jersey	15.37	1,052,000
21	Mississippi	15.47	341,000
22	Delaware	15.57	120,000
23	Iowa	15.73	378,000
24	Wisconsin	15.88	717,000
25	Missouri	15.93	746,000
26	Pennsylvania	15.94	1,589,000
27	Oklahoma	16.07	474,000
28	Arizona	16.25	923,000
29	North Dakota	16.37	93,000
30	Louisiana	16.43	569,000
31	Alaska	16.57	87,000
32	New Mexico	16.58	265,000
33	Rhode Island	16.66	140,000
34	Connecticut	16.66	465,000
35	Illinois	16.69	1,607,000
36	California	16.70	5,027,000
37	Michigan	16.72	1,295,000
38	New Hampshire	17.00	186,000
39	Colorado	17.25	771,000
40	Minnesota	17.26	742,000
41	Maine	17.32	188,000
42	Massachusetts	17.41	955,000
43	Wyoming	17.57	77,000
44	Vermont	17.69	89,000
45	Nebraska	18.00	258,000
46	Kansas	18.42	398,000
47	South Dakota	18.55	122,000
48	Washington	18.59	1,100,000
49	Oregon	19.13	639,000
50	Montana	19.22	161,000
51	District of Columbia	21.21	122,000
52	National	15.35	38,679,000

Adults with Serious Thoughts of Suicide 2023

The percentage of adults reporting serious thoughts of suicide is 4.84%. The estimated number of adults with serious suicidal thoughts is over 12.1 million.

11% of adults who identified as two or more races reported serious thoughts of suicide in 2020 – 6% higher than the average among all adults.

The state prevalence of adults with serious thoughts of suicide ranges from 3.92% in Georgia to 7.63% in Utah.

Rank Sort ascending	State	Percentage	Number
01	Georgia	3.92	313,000
02	New Jersey	4.12	283,000
03	Texas	4.18	892,000
04	Florida	4.26	727,000
05	North Carolina	4.30	346,000
06	District of Columbia	4.30	25,000
07	New York	4.34	659,000
08	California	4.39	1,323,000
09	Connecticut	4.40	123,000
10	South Carolina	4.42	176,000
11	Louisiana	4.50	156,000
12	Illinois	4.54	438,000
13	Tennessee	4.58	240,000
14	Virginia	4.58	298,000
15	New Hampshire	4.62	50,000
16	Hawaii	4.62	49,000
17	Mississippi	4.65	103,000
18	Delaware	4.65	35,000
19	Maryland	4.67	216,000
20	Massachusetts	4.74	260,000
21	New Mexico	4.82	77,000
22	Michigan	4.84	375,000
23	Wisconsin	4.85	219,000
24	Pennsylvania	4.86	485,000
25	Kentucky	4.89	166,000
26	Alabama	4.96	186,000
27	Maine	5.12	56,000
28	Rhode Island	5.17	43,000
29	Oklahoma	5.24	154,000
30	Nebraska	5.35	77,000
31	Iowa	5.38	129,000
32	Vermont	5.40	27,000
33	West Virginia	5.42	76,000
34	Missouri	5.47	256,000
35	Nevada	5.52	131,000
36	Arkansas	5.59	127,000
37	Washington	5.62	331,000
38	North Dakota	5.62	32,000
39	Indiana	5.82	296,000
40	Minnesota	5.96	256,000
41	Colorado	6.01	267,000
42	Ohio	6.01	538,000
43	Wyoming	6.02	26,000
44	South Dakota	6.08	40,000
45	Alaska	6.15	32,000
46	Montana	6.24	52,000
47	Idaho	6.27	84,000
48	Kansas	6.44	139,000
49	Arizona	6.48	364,000
50	Oregon	6.80	226,000
51	Utah	7.63	174,000
52	National	4.84	12,151,000

Adults with AMI Who Are Uninsured 2023

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 Sort ascending	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

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 Sort ascending	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

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 Sort ascending	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

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 Sort ascending	State	Percentage	Number
01	Hawaii	11.57	13,648
02	Pennsylvania	14.75	209,776
03	District of Columbia	14.83	12,140
04	Connecticut	15.35	53,772
05	Kentucky	16.39	97,416
06	Michigan	16.83	205,536
07	California	17	658,424
08	Vermont	17.16	12,194
09	Rhode Island	17.92	19,965
10	Maryland	18.13	102,697
11	New York	18.27	348,382
12	Iowa	18.87	58,543
13	Maine	19.27	26,122
14	Illinois	19.29	186,001
15	Massachusetts	20.24	142,667
16	New Mexico	20.29	42,779
17	Ohio	20.54	277,247
18	Tennessee	20.58	173,910
19	New Hampshire	20.77	31,115
20	Minnesota	20.8	108,531
21	Washington	20.92	171,306
22	Oregon	21.03	96,908
23	Wisconsin	21.32	120,787
24	West Virginia	21.44	52,220
25	New Jersey	21.63	182,587
26	Delaware	21.71	20,550
27	Nevada	21.8	90,995
28	Utah	22.77	78,444
29	Montana	23.08	24,917
30	Alaska	23.1	12,323
31	Colorado	23.13	133,747
32	North Dakota	23.29	15,270
33	Indiana	23.46	182,826
34	Arizona	23.6	179,024
35	Idaho	24.17	41,330
36	Virginia	24.85	200,556
37	Louisiana	25.66	155,523
38	South Dakota	26.23	16,433
39	Nebraska	26.77	46,180
40	North Carolina	27.03	285,522
41	Kansas	27.21	82,583
42	Missouri	27.35	196,596
43	Mississippi	28.18	90,084
44	Alabama	28.7	171,538
45	South Carolina	29.06	172,836
46	Arkansas	29.26	118,943
47	Oklahoma	29.48	135,994
48	Florida	30.07	635,806
49	Texas	31.51	893,651
50	Wyoming	34.22	17,878
51	Georgia	34.35	397,790
52	National	22.87	7,863,573